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.

Surgical biopsies can be excisional (removal of an entire lump or abnormal area) or incisional (removal of a piece of a lump or abnormal area).

Surgical biopsies can be done on abnormalities that can be seen or felt by the surgeon. They are also done on abnormalities that cannot be felt but are seen on pre-operative imaging such as ultrasound, CT scan and mammography. A sample is looked at under a microscope and can show a type of cancer or a non-cancerous condition.

A surgical biopsy may be done in a doctor’s office or hospital. A local anesthetic with or without sedation or a general anesthetic may be used, depending on the size and location of the lump.

• The surgeon makes a small cut or incision in the skin above the abnormal area. If the lump can’t be felt, imaging tests can be used to guide the surgeon. A wire or clip may be placed during the imaging test to guide the surgeon to the abnormal area.
• For an excisional biopsy, the surgeon removes 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 are needed to close the incision.
• Tissues removed from the body are sent to a lab to be looked atunder 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.

Side effects can happen with any surgery, but not everyone has them or experiences them in the same way. Side effects of a surgical biopsy are usually short term and may include:

• slight bleeding or bruising
• tenderness
• pain
• infection
• problems with the wound healing

Surgical biopsy of the breast may result in a change in the shape of the breast. This depends on the size and location of the lump or abnormal area and the amount of surrounding tissue that is removed.

The pathology report shows the type of cells present, their characteristics and whether they are normal, cancerous or abnormal but not 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.

The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.

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, including what they will see, feel and hear.

Preparing a child for a surgical biopsy depends on the age and experience of the child. Find out more about helping your child cope with tests and treatments.