A biopsy involves removing a sample of tissue or tumour from the body and examining it under a microscope for cancer cells. Biopsies are used to diagnose a cancer and to determine the extent of disease during the staging process.
Tissue or cell samples can be taken from almost any part of the body. The type of biopsy used depends on the area of the body to be biopsied and the type of cancer suspected.
There are several different kinds of biopsy procedures:
|Type of biopsy||Example|
scrape or brush biopsy
surgical (open) biopsy
Why a biopsy is done
A biopsy may be done to:
- screen for cancer
- diagnosis cancer
- remove a lump or mass of cells
- find out if cancer has spread and if it is present in nearby lymph nodes or organs
How a biopsy is done
Depending on the type of biopsy, it may be done in a clinic or hospital as an outpatient or inpatient procedure.
- A local or general anesthetic may be used, depending on the:
- type of specimen being taken
- location and size of the mass
- type of procedure
- person’s personal preference
- doctor’s preference
- A biopsy may involve removing a small amount of tissue with a needle or surgically removing an entire lump.
- Imaging techniques, such as ultrasound or CT scan, may be used to pinpoint the area to be biopsied.
- Samples of tissue can be removed with:
- a special needle
- a brush
- a snare
- a scalpel
- other biopsy instruments
- Cells or tissues removed from the body are sent to a laboratory to be examined under a microscope.
Some people are concerned that having a biopsy or exposing cancer to the air during a surgical procedure will spread the cancer.
- Exposure to air does not cause cancer to spread.
- Doctors take precautions to prevent cancer from spreading into healthy tissue during biopsies.
- The benefits of doing the biopsy usually outweigh the risks.
Potential side effects
The potential side effects of a biopsy depend on the type of biopsy performed. They may include:
- infection at the site
- bleeding under the skin where the needle was placed, at the incision site or in the tissue or organ
What the results mean
The pathology report indicates the characteristics and type of cells present, and if cells are normal, non-cancerous or cancerous.
If the microscopic examination shows cells are cancerous, they may be studied further. Various tissue tests may be done to:
- identify the type of tumour
- see how fast cancer cells are growing and how closely they resemble normal cells (differentiation)
- see if cancer cells have invaded the normal margin of tissue that was also removed
What happens if a change or abnormality is found
The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.
Special considerations for children
When doctors suspect that a child might have cancer, biopsies may be done at a pediatric cancer centre. This is especially important if the tumour requires surgery as part of the treatment because poor biopsy technique can affect the success of future surgeries.
Some biopsies are performed in the treatment room of a children’s hospital ward using local anesthetic. Others are done in the operating room under general anesthetic. The type of biopsy needed depends on many factors, including the characteristics and location of the tumour. Parents and children should discuss the procedure with the healthcare team and have all their questions answered completely.
To help prepare children for a biopsy:
- Tell them that they will be going to the hospital for the procedure and what will happen at the hospital.
- Tell children when they will have the biopsy and how long it will take.
- The child can bring a favourite toy, doll, pacifier or blanket to the hospital.
- Have books, magazines, games or music to keep the child entertained while waiting for the biopsy.
- If children will have general anesthetic, let them know:
- They will not feel, hear or see anything during the operation because of a special sleep medicine.
- They will wake up when it is over.
- If children have local anesthetic and are awake during the procedure, they may feel a burning or stinging when the anesthetic is injected and may feel some pressure or “tugging.”
- The area of the biopsy may be sore for about a week after the procedure.
The preparation you can provide for a biopsy depends on the age and experience of the child. See the following for more age-specific information on helping children cope with tests and treatment.
The study of disease, including causes, development and effects on the body.
The symptoms, processes or conditions of a disease.
A doctor who specializes in the causes and nature of disease is called a pathologist. Pathologists help determine diagnosis, prognosis and treatment by studying cells and tissues under a microscope and using laboratory tests.
Pathological means referring to or having to do with pathology. It can also refer to something related to or caused by a disease, as in pathological fracture.
The normal process by which immature (unspecialized) cells develop individual characteristics to become mature (specialized) cells.
Differentiation is used to describe the extent to which cancerous cells resemble normal cells. Differentiated cancer cells look and act like normal cells; they tend to grow and spread slowly. Undifferentiated cancer cells do not look or act like normal cells; they tend to grow and spread quickly.