A biopsy is a procedure to remove a sample of tissue or tumour from the body for examination under a microscope. Biopsies are used to diagnose cancer or find out whether an abnormality is non-cancerous.
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 possible cancer.
Types of biopsy
There are several different kinds of biopsy.
Needle biopsies include the following:
- A fine needle aspiration uses a very thin needle and syringe to remove a sample of cells, tissue or fluid from an abnormal area or lump in the body.
- A core needle biopsy uses a hollow needle to remove tissue from the body.
- A bone marrow aspiration uses a needle to withdraw a small amount of bone marrow from the hip bone.
- A lumbar puncture uses a needle to remove cerebrospinal fluid from the spinal column.
A vacuum-assisted biopsy is a core biopsy that is helped by suction from a vacuum device. It can remove multiple samples of tissue with only one needle insertion. It is being used more often for breast biopsies.
A scrape or brush biopsy is used to scrape cells from the surface of a sore or growth or from the cervix during a Pap test.
A punch biopsy is most often used to take a sample of a skin rash or growth on the skin. A punch biopsy may also be used to remove a small sample of tissue from the cervix.
Surgical or open biopsies include the following:
- An excisional biopsy removes the whole tumour or abnormal tissue along with a margin of tissue around it.
- An incisional biopsy removes a small sample of the tumour or abnormal tissue.
- A lymph node dissection removes an area of lymph nodes.
Endoscopic biopsies are biopsies done during an endoscopy. An endoscopy uses a hollow, tube-like tool with a light on the end (an endoscope) to look inside certain body cavities. The doctor might then take a sample of tissue for examination. Some endoscopies that might be done to take a biopsy include a cystoscopy, a bronchoscopy and a laryngoscopy.
Why a biopsy is done
A biopsy may be done to:
- look for cancer
- diagnose cancer
- find out how far the cancer has spread (the stage)
- find out the grade of a cancer
How a biopsy is done
Depending on the type of biopsy, it may be done as an outpatient or in-patient procedure in a clinic or hospital. A local or general anesthetic may be used depending on the size and location of the biopsy site.
- A biopsy removes a small amount of tissue or an entire tumour.
- Imaging techniques such as ultrasound or a CT scan may be used to identify the area to be biopsied.
- Samples of tissue can be removed with a special needle, a brush, a scalpel or other instrument.
- Cells or tissues that are removed are sent to a lab to be looked atunder a microscope.
Doctors take steps to prevent cancer from spreading into healthy tissue during biopsies.
Side effects can happen with any type of surgery, but everyone’s experience is different. The side effects of a biopsy depend on the type of biopsy done. They may include:
- infection at the biopsy site
What the results mean
Biopsy samples are sent to a pathology lab. A pathologist (a doctor who specializes in the causes and nature of disease) looks at the cells to see if they contain cancer. The pathology report shows the type of cells present, their characteristics and whether they are normal, cancerous or abnormal but non-cancerous.
If the report shows that the cells are cancerous, they may need to be studied further. You may need further tests to find out the type of tumour, how fast the cells are growing and if cancer cells have spread to the surrounding normal tissue.
What happens if the result is abnormal
Your doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.
Special considerations for children
Preparing children before a test or procedure can lower anxiety, increase cooperation and help them develop coping skills. Preparation includes explaining to children what will happen during the test, such as what they will see, feel and hear.
Preparing a child for test depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.
A procedure that uses an endoscope (a thin, tube-like instrument with a light and lens) to examine or treat the bladder and urethra.
Cells or tissue may be removed for examination under a microscope. Doctors may also use cystoscopy to remove the prostate or small tumours or stones from the bladder.
The type of endoscope used for this procedure is called a cystoscope.
A procedure that uses an endoscope (a thin, tube-like instrument with a light and lens) to examine or treat the trachea (windpipe), bronchi and lungs.
Cells or tissues may be removed for examination under a microscope. Doctors may also use bronchoscopy to control bleeding or remove tumours or foreign bodies.
The type of endoscope used for this procedure is called a bronchoscope. A rigid bronchoscope is a hollow metal tube used for procedures that need greater access to the lungs, such as controlling bleeding or removing foreign bodies or tumours. A flexible bronchoscope is a thin tube that contains fibre-optic bundles that transmit images from a camera at the tip of the instrument. Doctors use a flexible bronchoscope to examine and collect tissue deep inside the bronchi and lungs.
A procedure that uses an endoscope (a thin, tube-like instrument with a light and lens) to examine or treat the larynx (voice box) and vocal cords.
Cells or tissue may be removed for examination under a microscope.
The type of endoscope used for this procedure is called a laryngoscope.
Great progress has been made
Some cancers, such as thyroid and testicular, have survival rates of over 90%. Other cancers, such as pancreatic, brain and esophageal, continue to have very low survival rates.