Biopsy

A biopsy is a medical procedure that involves the collection of a tissue or a small sample from your body for closer analysis.

This procedure is often performed to diagnose cancer or some other medical condition. A biopsy can be taken in different ways depending on your situation; your doctor may surgically remove a piece of tissue, skin, suspected tumor, or organ and send it to a lab for further testing.

While the idea of having a biopsy may sound scary, it’s important to note that most procedures are low-risk and entirely pain-free.

Why is a biopsy done?

Your doctor may order or recommend a biopsy if you have been experiencing cancer-related symptoms. Once he or she has located an area of concern, a sample will be needed to help determine if the said area is cancerous.

Most cancers can only be diagnosed through a biopsy. While imaging tests like X-rays and CT scans can help identify areas of concern, they can’t really differentiate between noncancerous and cancerous cells.

Although biopsies are frequently associated with cancer, it doesn’t mean that you have one just because your doctor ordered a biopsy. Biopsies are used to determine whether abnormalities in your body are a result of cancer or some other medical conditions.

For instance, if a woman notices a lump in her breast, an imaging scan can be used to confirm the lump’s presence. Still, a biopsy is the only sure way to determine whether she has breast cancer or some other noncancerous condition like polycystic fibrosis.

What are the types of biopsy?

Skin biopsy

If you develop a lesion or rash on your skin that doesn’t respond to prescribed treatment or resembles a symptom of a specific condition or the cause of which is unknown, your health care provider may order or perform a biopsy of the affected area of your skin.

This can be carried out by using local anesthesia and taking a small piece of the affected area with a scalpel, a razor blade, or a small circular blade called a “punch.”

The specimen will be sent to a laboratory to look for evidence of conditions such as cancer, infection, and inflammation of the blood vessels or skin structure.

Needle Biopsies

Needle biopsies are used to retrieve skin samples or tumors that can be felt through the skin, such as enlarged lymph nodes and suspicious breast lumps.

The following are the different type of needle biopsies:

  • Fine needle biopsy: Fine needle aspiration is done by inserting a long thin needle that is attached to a syringe into the suspected area, allowing cells and fluids to be drawn out for analysis.
  • Core needle biopsies: In a core needle biopsy, a medium-sized needle with a cutting clip is used to extract a column of tissue out of the affected area; the same way core samples are drawn from the earth.
  • Vacuum-assisted biopsies: A suction device is used during this procedure to increase the amount of cells and fluids that are taken through the needle.
  • Image-guided biopsy: During this procedure, the needle is guided with an imagining method – such as computerized tomography (CT), X-ray, ultrasound, or magnetic resonance imaging (MRI). This allows your doctor to gain access to suspicious areas that can’t be felt through the skin, such as the liver, lung, or other organs.

Endoscopic biopsy

Endoscopic biopsies are used to collect tissue samples from your internal organs. In this procedure, an endoscope (a thin, flexible tube fitted with a light and a tiny camera at the end) is passed inside your body.

A monitor is connected to the endoscope, allowing your doctor to navigate through the structures in your body. Special tools are also inserted through the endoscope to collect a small tissue sample for analysis.

The type of endoscopic biopsy you undergo depends on the area that may be affected. The endoscopy can be inserted through the mouth, urinary tract, rectum, or a small incision in your body.

The process usually takes anywhere from five to 20 minutes. Examples of endoscopic biopsy procedures include bronchoscopy to collect tissue from inside your lung, cystoscopy to get tissue from inside your bladder, and colonoscopy get tissue from inside your colon.

An endoscopic biopsy can be carried out in a hospital or a doctor’s office. After the procedure, you may feel mildly uncomfortable, have a sore throat, gas, or bloating. These will resolve in time, but you can speak with your doctor if you feel concerned.

Bone marrow biopsy

Marrows are the spongy materials found inside some of your larger bones like the hipbone, or the femur in your leg, where blood cells are produced.

This procedure may be recommended if your doctor suspects there are problems with your blood. Bone marrow biopsy can single out different kinds of conditions – both cancerous and noncancerous – like anemia, leukemia, multiple myeloma, infection, or lymphoma. It can also detect if cancers that started elsewhere have spread to your bones.

During a bone marrow biopsy, a long needle is inserted into the back of your hip bone to draw out the bone marrow. In some cases, marrow may be biopsied from other bones in your body.

A local sedative of anesthetic is applied before the procedure; however, some people may experience dull pain during the process as the insides of your bones cannot be numbed. The anesthetic will only help reduce the amount of pain felt.

Surgical biopsy

Your doctor may order a surgical biopsy if the cell in question can’t be safely or effectively accessed using other biopsies or if the results from other biopsy specimen are inconclusive.

This procedure involves making an incision in your skin to access the affected area of cells. An example would be removing a breast lump for a possible breast cancer diagnosis.

Surgical biopsies can be used either to collect a part of an abnormal cell area (incisional biopsy) or to remove an entire area of suspicious cells (excisional biopsy).

What are the risks of a biopsy?

There may be a small risk of infection or bleeding from the biopsy site, but generally, biopsy procedures are considered safe.

However, open biopsies such as surgical biopsies may carry some additional risks as they involve surgical procedures and general anesthesia.

Following up after a biopsy

Once the procedure has been completed, check-in with your doctor to know when your biopsy results will be available. Results may return immediately, or in some cases, it may take a day or two.

When should you call a doctor?

While some symptoms like swelling or sore throat may resolve after a few days, you should seek medical help immediately is you experience any of the following:

  • Fever
  • Pain, redness, swelling, bleeding or pus at the surgical site
  • Pain, redness, swelling, bleeding or pus at the biopsy site
  • Any other symptoms your doctor instructs you to watch for

Other information you should note

New laboratory techniques can be used to test biopsy samples for other elements such as genetic change or proteins. This information can help make precise diagnose and also determine individualized cancer therapy to help fight certain cancers.

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