Biopsy

What is a biopsy?

A biopsy removes a piece of tissue for testing. After tissue is removed, it is sent to a lab where technicians view it under a microscope or do other tests. Biopsies are used to help diagnose infections, cancer, and other diseases. They may be done in different ways, depending on the part of the body and kind of tissue needed. Some biopsies simply require a puncture with a needle. Others may involve passing a thin scope into the body. Still others may need surgery.

Common types of biopsies are:

• skin biopsy
• needle aspiration
• endoscopic biopsy, including laparoscopic biopsy
• surgical biopsy
• bone marrow biopsy.

What is a skin biopsy?

Skin biopsy is the removal of a small piece of skin. There are 3 types of skin biopsy: incisional, shave, and punch.

• For an incisional biopsy, a knife called a scalpel is used to take small piece of skin. An excisional biopsy is a special kind of incisional biopsy: a whole lump or abnormal area is taken out rather than just a sample. The skin is then sewn back together.
• A punch biopsy is done with a sharp, circular knife, which takes a little circle of skin about one quarter inch wide and deep. This allows deeper layers of skin to be examined.
• A shave biopsy is the removal of just the surface of a usually tiny piece of skin. It may also be used to remove a small growth on the skin. A scalpel or razor-blade-like tool is used to skim the surface.

What is needle aspiration?

For a needle or fine needle aspiration or biopsy, your provider puts a long, very thin but hollow needle through the skin into an organ needing biopsy, for example, the breast or liver. Sometimes this is done in the x-ray department so the lump or abnormal tissue can be seen with an x-ray or ultrasound scan. This helps your provider put the needle in exactly the right place. A core biopsy uses a slightly larger needle to remove a small, solid core of tissue. Tissue is sucked into the needle and sent to the lab.

What is endoscopic biopsy?

Endoscopic biopsy can be used to get samples of many different internal organs. This includes the digestive system, the lungs, and the bladder. These biopsies are done with a long, thin, flexible, lighted tube. The tube is passed into the mouth, rectum, or urethra (the tube that drains the bladder), depending on where the suspected abnormal tissue is. Laparoscopic biopsy is a special type of endoscopic biopsy. The laparoscope is put through a tiny cut in your belly. The laparoscope is very much like the endoscope. It allows many of the organs in the abdomen to be seen and biopsied with the use of tools that fit through the opening of the scope. It is especially good for seeing the organs in a woman's pelvis, such as the ovaries.

Before the invention of the endoscope, these biopsies could be done only as open surgery. Open surgery requires a larger cut in the body, more anesthesia, longer operating time, and more time for recovery.

What is surgical biopsy?

A surgical biopsy is obtained by a surgeon either by removing the entire organ (excisional biopsy) or a small piece of tissue of the organ (incisional biopsy).

What is a bone marrow biopsy?

A bone marrow biopsy is a way to look at the center of the bone. It may be done to look for bone problems and for some cancers of the blood, such as leukemia. It is usually done in the breastbone or the hipbone just below the waist. A hollow needle is used to suck the marrow up into the needle barrel.

Will I have anesthesia for a biopsy?

A shave biopsy may require very little or no anesthesia or numbing. The other skin biopsies are normally done after a shot of a local anesthetic to numb the area that will be cut. A needle biopsy usually also requires just a local anesthetic.

A type of anesthesia called conscious sedation is usually used for endoscopic biopsies. This means you are given pain medicine and a medicine that relaxes you.

Laparoscopic biopsy is done under general anesthesia, which relaxes your muscles, puts you to sleep, and keeps you from feeling pain.

For a bone marrow biopsy, just the skin above the bone to be sampled is numbed with a local anesthetic.

How can I take care of myself?

• Follow your health care provider's instructions for preparation for the biopsy, including whether you need to have someone drive you home.
• After your biopsy, follow your provider's instructions for taking care of your wound, if you have one.
• Ask your provider how you will get your results and how soon you should return for follow-up.
• Call your provider if you have a fever, worsening pain, or unexpected bleeding.
• Keep all follow-up appointments.