A punch biopsy is a type of biopsy where a round area of skin and underlying tissue is removed using a sharp hollow cutting instrument.
Why punch biopsy is done
Punch biopsy is done to:
- diagnose certain types of cancer that appear on or in the skin – most common use
- diagnose other skin diseases
- non-cancerous (benign) growths
- skin infections
- completely remove a benign lesion from the skin
- help plan cancer surgery
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How punch biopsy is done
A punch biopsy does not usually need any special preparation and does not take very long to do. It is often done in a doctor's office or clinic.
- The area is frozen with a local anesthetic.
- The skin in the area is stretched.
- Stretching the skin makes it easier to close the incision, and leaves a less noticeable scar.
- A round, hollow cutting instrument is placed over the area.
- The instrument is pushed down through the layers of the skin into the underlying fat.
- A round core of tissue is removed from the area.
- The tissue is sent to a laboratory to be examined under a microscope.
After the biopsy is done:
- Ice and pressure may be applied to the area.
- The area may be closed using 1 or 2 stitches.
- A small bandage may be used to cover the biopsy site.
- A person may resume normal activities after 24 hours.
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Potential side effects
Side effects can occur with any type of procedure, but not everyone has them or experiences them in the same way. Most side effects of punch biopsy are short term and may include:
- slight bleeding or bruising
- tenderness
- pain
- Some people experience pain during the procedure.
- infection
- scarring
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What the results mean
Biopsy samples are sent to the pathology lab. A pathologist (a doctor who specializes in the causes and nature of disease) will look at the cells in the tissue to see if they contain cancer. The pathology report indicates the characteristics and type of cells present and if cells are normal, non-cancerous or cancerous.
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What happens if a change or abnormality is found
Based on the results of a punch biopsy, the doctor with decide whether or not further tests, surgery or other procedures are needed.
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Limitations of punch biopsy
A punch biopsy should not be done on a skin lesion if it is coloured (pigmented) and could potentially be melanoma (a type of skin cancer).
A punch biopsy may not be done if the procedure might damage vital structures or nerves in the area to be sampled.
In rare situations, a punch biopsy may miss sampling the area completely, or miss other areas that are actually cancerous.
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