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Surgical biopsy

A surgical biopsy is a procedure that involves the surgical removal of tissue from a lump or mass for examination under a microscope. This test may also be called an open biopsy.

There are 2 basic types of surgical biopsy:

  • excisional biopsy – removal of the entire abnormal area or lump
  • incisional biopsy – removal of part of a lump or abnormal area

Why surgical biopsy is done

Surgical biopsy is used to:

  • remove a piece of tissue from an area the doctor suspects is cancerous
  • remove lumps (excisional biopsy)
  • remove a portion of a large lump (incisional biopsy)
    • Incisional biopsy may be used if:
      • completely removing the lump would cause a deformity
      • it is impossible to remove the entire lump
  • diagnose cancer

How surgical biopsy is done

A surgical biopsy may be done in the doctor’s office or in the hospital on an outpatient basis. Small lumps that can be felt (palpable) and non-palpable lumps can be removed with surgical biopsy.

  • Local or general anesthetic may be used, depending on the size and location of the lump.
  • The doctor makes a small cut or incision in the skin above the abnormal area.
    • Imaging tests, such as ultrasound or CT scan, can be used to guide the surgeon to the lump.
    • A wire may be placed during the imaging test to guide the surgeon to the lump (wire localization biopsy).
  • For an excisional biopsy, the surgeon will remove the entire lump or abnormal area, along with a small amount (margin) of normal tissue surrounding the lump.
  • For an incisional biopsy, the surgeon removes only a small part of the lump.
  • Stitches or staples may be needed to close the incision.
  • The sample 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.
    • A small bandage is used to cover the biopsy site.
    • The person may resume normal activities after 24 hours.

Potential side effects

Side effects can occur with any surgical procedure, but not everyone has them or experiences them in the same way. Most side effects of surgical biopsy are short term and may include:

  • slight bleeding or bruising
  • tenderness
  • pain
  • infection

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.

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.

An excisional biopsy may be all the treatment required for some very early cancers.

Special considerations for children

Being prepared for a test or procedure can reduce anxiety, increase cooperation and help the child develop coping skills. Parents or caregivers can help prepare children by explaining to them what will happen, including what they will see, feel and hear during the test.

The preparation you can provide for this test 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.

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