BIOPSY

What are biopsies?

A biopsy is the removal of tissue in order to examine it for disease. The tissue samples can be taken from any part of the body. Biopsies are performed in several different ways. Some biopsies involve removing a small amount of tissue with a needle while others involve surgically removing an entire lump, or nodule, that is suspicious.

Most needle biopsies are performed in an outpatient setting with minimal preparation necessary. When you schedule your biopsy appointment, you will receive detailed instructions about preparation for the biopsy procedure. If you are having a needle or surgical biopsy, ask your health care provider if you need to stop taking any medications before the procedure.

You may be instructed not eat or drink for eight hours before your biopsy. However, you may take your routine medications with sips of water. If you are diabetic and take insulin, you should talk to your doctor as your usual insulin dose may need to be adjusted. Prior to a needle biopsy, you should report to your doctor all medications that you are taking, including herbal supplements, and if you have any allergies, especially to anesthesia. Your physician may advise you to stop taking aspirin or a blood thinner for a specific period of time before your procedure.

 

Also, inform your doctor about recent illnesses and other medical conditions. You may be asked to wear a gown during the procedure. You may want to have a relative or friend accompany you and drive you home afterward. This is necessary if you have been sedated. Preparation for a biopsy procedure will be similar for children. If your child is undergoing a biopsy procedure, the physician will provide you with instructions.

What will I experience during and after the procedure?

In a needle biopsy, you will feel a small sharp pinch at the site of the biopsy. In an open or closed biopsy that requires surgery, you will be given anesthesia to help with the pain. When you receive the local anesthetic to numb the skin, you will feel a slight pin prick from the needle. You may feel some pressure when the biopsy needle is inserted. The area will become numb within a short time.

You may be given a mild sedative prior to the biopsy, and sedation or relaxation medication may be given intravenously during the procedure if needed.

 

You may feel sore at the area of the biopsy for a few days. Your doctor can prescribe pain relief medication if you have significant pain from the biopsy. Aftercare instructions vary, but generally your bandage may be removed one day following the procedure, and you may bathe or shower as normal.

What are the benefits vs. risks?

• Needle biopsy is a reliable method of obtaining tissue samples that can help diagnose whether a nodule is benign (non-cancerous) or malignant.
• A needle biopsy is less invasive than open and closed surgical biopsies, both of which involve a larger incision in the skin and local or general anesthesia.
• Generally, the procedure is not painful and the results are as accurate as when a tissue sample is removed surgically.
• Recovery time is brief and patients can soon resume their usual activities.
• Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.

What are the limitations of biopsies?

In some cases, the amount of tissue obtained from a needle biopsy may not be sufficient and the biopsy may have to be repeated. This may be particularly true with trying to make a diagnosis of lymphoma. Rarely, less invasive breast biopsy procedures may be unable to detect some lesions or determine the extent of disease present. If the diagnosis remains uncertain after a technically successful procedure, surgical biopsy will usually be necessary.

Any imaging-guided procedure will not be able to be used unless the area of abnormality can be seen. Some lesions, such as clustered calcifications on mammography are not as clearly shown with ultrasound as they are with mammography. Therefore, stereotactic biopsy is usually used in breast imaging to biopsy calcifications. Fluoroscopy sometimes will not be able to locate chest nodules, and CT will be used for guidance. Your radiologist will use the image guidance best suited to biopsy the area in question.

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