Biopsy -- Detailed
A biopsy is the removal of a sample of tissue from the body for examination under a microscope. Biopsies are used to diagnose many medical conditions, from skin problems to cancer.
Who is a candidate for the test?
Anyone whose medical condition needs a specific diagnosis may need a biopsy. A biopsy may also be needed to monitor a disease or condition.
How is the test performed?
There are several different kinds of biopsy.
In an excisional biopsy, a whole organ or whole lump is removed by surgery. This may require general anesthesia. General anesthesia means that a person is put to sleep with medications, has no awareness of the procedure, and feels no pain. This kind of biopsy is often used to diagnose cancer.
For an incisional biopsy, the surgeon cuts out a small piece of the tissue or lump. This may require general or local anesthesia. Local anesthesia means that medicine is injected locally in an area to numb it, but the person stays awake. This kind of biopsy is used to diagnose some cancers. It is also used to determine the difference between normal and diseased tissue.
A punch biopsy removes a small piece of skin using a sharp punch tool. The punch only cuts through the top layers of skin. The skin is cleaned and numbed first with local anesthesia or topical anesthesia. A punch biopsy is used to diagnose skin conditions.
In a needle biopsy or fine-needle aspiration (FNA), a needle is inserted through the skin into the tissue. Tiny amounts of tissue are then sucked out through the needle. This is usually done under local anesthesia. This kind of biopsy is used to diagnose liver problems, thyroid disease, and breast cancer. It is also used for other conditions, especially tumors in organs that are hard to reach.
In a bone marrow biopsy or aspiration, a needle is inserted into a bone, usually the hip bone, or pelvis. Bone marrow cells are sucked out of the inside of the bone. This sometimes causes moderate pain. This kind of biopsy is usually done under local anesthesia. It is used to diagnose leukemia, other cancers, and low blood counts in some situations.
An endoscopic biopsy uses an endoscope, a lighted, flexible tube, to get the tissue. The endoscope may be inserted through the skin with local anesthesia in order to reach deeper tissues. It can also be inserted into the bowel from the top or bottom, or into the lungs, bladder, or uterus. The endoscope is used to see the abnormal tissue. Then, a tiny tool can be placed through the endoscope. The tool can take a small piece of the abnormal tissue. Endoscopic biopsy can be used to diagnose many different diseases and conditions.
A colposcopy-directed biopsyuses a colposcope, which is a special microscope for examining the cervix. The cervix is the lower part of the uterus that connects to the vagina. This kind of biopsy usually requires no anesthesia. It is used to collect abnormal tissue from the cervix, usually after a woman has an abnormal Pap smear.
In a stereotactic biopsy, special X-ray tests are used to guide the healthcare professional. This allows the examiner to insert a biopsy needle into the abnormal area. It is used when the abnormal tissue cannot be seen or felt directly, and helps make sure that the needle does not miss the abnormal tissue to one side or the other. It is often used when abnormalities are found on X-ray tests, such as mammography or a CT scan.
What is involved in preparation for the test?
Usually no special preparation is needed. The healthcare professional will give any special instructions. A person may not eat or drink for several hours before general anesthesia.
What do the test results mean?
It may take several days for the results to come back. The healthcare professional will discuss the results and what they mean.