A biopsy is the removal of tissue from any part of the body to examine it for disease. Some may remove a small tissue sample with a needle while others may surgically remove a suspicious nodule or lump. Show
Most needle biopsies are performed on an outpatient basis with minimal preparation. Your doctor will give you instructions based on the type of biopsy being performed. Tell your doctor if there's a possibility you are pregnant. Discuss any medications you're taking, including blood thinners such as aspirin and herbal supplements, and whether you have any allergies – especially to anesthesia. Your physician will advise you to stop taking blood thinners for a specific period of time before your procedure, and you may be told not to eat or drink anything for eight hours beforehand. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. What are biopsies?A biopsy is the removal of tissue in order to examine it for disease. The tissue samples can be taken from any part of the body. Biopsies are performed in several different ways. Some biopsies involve removing a small amount of tissue with a needle while others involve surgically removing an entire lump, or nodule, that is suspicious. Often, the tissue is removed by placing a needle through the skin (percutaneously) to the area of abnormality. Biopsies can be safely performed with imaging guidance such as ultrasound, x-ray, computed tomography (CT), or magnetic resonance imaging (MRI). These types of imaging are used to determine exactly where to place the needle and perform the biopsy. top of page What are some common uses of the procedure?When your doctor finds a nodule, they may order imaging tests to help determine if it is benign (non-cancerous) or malignant (cancerous). If imaging exams cannot clearly define the abnormality, a biopsy may be necessary. Usually, a biopsy is performed to examine tissue for disease. Biopsies are frequently used to diagnose cancer, but they can help identify other conditions such as infections and inflammatory and autoimmune disorders. They may also be done to match organ tissue before a transplant and to look for signs of organ rejection following a transplant. Biopsies are performed in many areas of the body and for many reasons. The following is a list of common biopsy types and why they may be necessary:
Almost any organ can be biopsied, including the bladder, heart, neck, prostate, parathyroid glands, etc. top of page How should I prepare?Most needle biopsies are performed in an outpatient setting with minimal preparation. When you schedule your biopsy appointment, you will receive detailed instructions about preparation for the biopsy procedure. If you are having a needle or surgical biopsy, ask your health care provider if you need to stop taking any medications before the procedure. Your doctor may tell you not to eat or drink for eight hours before your biopsy. However, you may take your routine medications with sips of water. If you are diabetic and take insulin, ask your doctor if you need to adjust your usual insulin dose. Prior to a needle biopsy, tell your doctor about all the medications you take, including herbal supplements. List any allergies, especially to anesthesia. Your doctor may tell you to stop taking aspirin or a blood thinner for a time before your procedure. Also, tell your doctor about recent illnesses and other medical conditions. You may need to change into a gown for the procedure. Women should always tell their doctor if there is any possibility that they are pregnant. Doctors do not perform some procedures that use image-guidance during pregnancy because radiation can be harmful to the fetus. See the Safety in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information about pregnancy and x-rays. You may want to have someone accompany you and drive you home afterward. This will be necessary if you receive sedation. Preparation for a biopsy procedure will be similar for children. If your child is undergoing a biopsy procedure, the physician will provide you with instructions. top of page What does the equipment look like?There are many different types of biopsy procedures. The equipment used for each type of biopsy will vary depending on the type of procedure. In needle biopsy, a sample of tissue or fluid is removed with a needle and sent to the laboratory for further analysis. A biopsy needle is generally several inches long. The barrel is about as wide as a large paper clip. The needle is hollow so it can capture the tissue specimen. A biopsy may use one of several types of needles. Common ones include:
Doctors perform needle biopsies with the guidance of computed tomography (CT), fluoroscopy, ultrasound, or MRI. A mammography unit is a box with a tube that produces x-rays. The unit is used exclusively for breast x-ray exams and features special accessories to limit x-ray exposure to only the breast. The unit features a device to hold and compress the breast and position it so the technologist can capture images at different angles. Ultrasound machines consist of a computer console, video monitor and an attached transducer. The transducer is a small hand-held device that resembles a microphone. Some exams may use different transducers (with different capabilities) during a single exam. The transducer sends out inaudible, high-frequency sound waves into the body and listens for the returning echoes. The same principles apply to sonar used by boats and submarines. The technologist applies a small amount of gel to the area under examination and places the transducer there. The gel allows sound waves to travel back and forth between the transducer and the area under examination. The ultrasound image is immediately visible on a video monitor. The computer creates the image based on the loudness (amplitude), pitch (frequency), and time it takes for the ultrasound signal to return to the transducer. It also considers what type of body structure and/or tissue the sound is traveling through. The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. You will lie on a narrow table that slides in and out of this short tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is in a separate control room. This is where the technologist operates the scanner and monitors your exam in direct visual contact. The technologist will be able to hear and talk to you using a speaker and microphone. A vacuum-assisted device (VAD) is a vacuum-powered instrument that uses pressure to pull tissue into the needle. In some situations, image guidance is used to help a surgeon to perform a surgical biopsy. A thin guide wire may be placed or marking dye injected with x-ray, ultrasound, or CT guidance to aid the surgeon in locating the correct area for a surgical biopsy. Other sterile equipment that may be involved in a biopsy procedure includes syringes, sponges, forceps, scalpels and a specimen cup or microscope slide. top of page How does the procedure work?The type of procedure used to perform the biopsy depends on the location of the tissue that needs to be examined. Most areas of the body can be biopsied with a needle device. This is the least invasive option, and usually allows for the patient to return home the same day. Imaging guidance with x-ray, ultrasound, CT or MRI allows for accurate placement of the needle to locate the best place to take a tissue sample. In hard to reach places, biopsies using surgery in a hospital operating room may sometimes be necessary. A surgeon will perform surgery to remove the tissue needed for the biopsy. The surgeon may use an instrument with a camera to help locate the best place to biopsy and remove the tissue sample. Using imaging guidance, the doctor inserts the needle through the skin and advances it into the lesion. They will remove tissue samples using one of several methods.
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How is the procedure performed?Imaging-guided, minimally invasive procedures, such as needle biopsies, are most often performed by a specially trained radiologist, an interventional radiologist or a neuroradiologist. Doctors usually perform needle biopsies on an outpatient basis. A nurse or technologist may insert an intravenous (IV) line into a vein in your hand or arm. This will allow them to provide sedation or relaxation medication intravenously during the procedure. You may also receive a mild sedative prior to the biopsy. The doctor will use a local anesthetic to numb the path of the needle. Some biopsies, such as breast or thyroid biopsies, may be performed without sedation. The nurse or technologist will advise you at the time of the procedure regarding the sedation. When a biopsy is performed on a child, it is more likely that general anesthesia will be required to keep them comfortable during the procedure. If the doctor is using fluoroscopy guidance, you will lie down or stand for the procedure. If the doctor is using CT or MRI guidance, you will lie down during the procedure. They will use a limited CT or MRI scan to confirm the location of the nodule and the safest approach for the targeted area. Once they confirm the nodule’s location, they will mark the entry site on the skin. The doctor will clean and disinfect the skin around the insertion site and cover it with a clean and sterile drape. The doctor will make a very small nick in the skin at the site where the biopsy needle will be inserted. Using imaging guidance, the doctor will insert the needle through the skin, advance it to the site of the nodule, and remove samples of tissue. They may need to collect several specimens for complete analysis. After the sampling, the doctor will remove the needle. Once the biopsy is complete, the doctor will apply pressure to stop any bleeding and cover the opening in the skin with a dressing. No sutures are needed. You may be taken to an observation area for several hours. The doctor may use X-ray(s) or other imaging tests to monitor for complications. Biopsy procedures are typically performed the same way for children. For stereotactic breast biopsies, you may lie face down or sit up on a moveable exam table and the affected breast or breasts will be positioned into openings in the table. In a fine needle aspiration, a fine gauge needle and a syringe withdraw fluid or clusters of cells. In a core needle biopsy, the automated mechanism is activated, moving the needle forward and filling the needle trough, or shallow receptacle, with 'cores' of breast tissue. The outer sheath instantly moves forward to cut the tissue and keep it in the trough. This process may be repeated several times. In some breast biopsies, the tissue is removed with a vacuum-assisted device (VAD). Vacuum pressure is used to pull tissue from the breast through the needle into the sampling chamber. Without withdrawing and reinserting the needle, it rotates positions and collects additional samples. Typically, several samples of tissue are collected from around the lesion. After this sampling, the needle will be removed. If a surgical biopsy is being performed, a wire may be inserted into the suspicious area as a guide for the surgeon. A small marker may be placed at the site, so that it can be located in the future if necessary. Once the biopsy is complete, pressure will be applied to stop any bleeding, and the skin will be covered with a dressing or bandage. Depending on the type of biopsy performed, you may be able to return home immediately after the procedure. This procedure is usually completed within one hour. You may be required to stay in an area for observation for several hours after the biopsy depending on the type of biopsy performed. top of page What will I experience during and after the procedure?In a needle biopsy, you will feel a small sharp pinch at the site of the biopsy. In an open or closed biopsy that requires surgery, you will be given anesthesia to help with the pain. When you receive the local anesthetic to numb the skin, you will feel a slight pin prick from the needle. You may feel some pressure when the biopsy needle is inserted. The area will become numb within a short time. You may receive a mild sedative prior to the biopsy. If needed, you may receive sedation or relaxation medication intravenously during the procedure. You may feel sore at the area of the biopsy for a few days. Your doctor can prescribe pain relief medication if you have significant pain from the biopsy. Aftercare instructions vary. However, you generally may remove your bandage one day after the procedure, and you may bathe or shower as normal. top of page Who interprets the results and how do I get them?After the tissue is collected, it is sent to a laboratory for analysis. A pathologist will examine the biopsy tissue under a microscope. A full report from the pathologist will be sent to your doctor in a few days. You should ask the doctor performing the procedure how you will receive your results. If you underwent a breast biopsy, it is likely the radiologist will discuss your results with you. Your interventional radiologist may recommend a follow-up visit. This visit may include a physical check-up, imaging exam(s), and blood tests. During your follow-up visit, tell your doctor if you have noticed any side effects or changes. top of page What are the benefits vs. risks?
Generally a biopsy procedure is safe and causes minimal injury. Complications that may result from biopsies include:
top of page What are the limitations of biopsies?In some cases, the amount of tissue obtained from a needle biopsy may not be sufficient and the biopsy may have to be repeated. This may be particularly true with trying to make a diagnosis of lymphoma. Rarely, less invasive breast biopsy procedures may be unable to detect some lesions or determine the extent of disease present. If the diagnosis remains uncertain after a technically successful procedure, surgical biopsy will usually be necessary. Any imaging-guided procedure will not be able to be used unless the area of abnormality can be seen. Some lesions, such as clustered calcifications on mammography are not as clearly shown with ultrasound as they are with mammography. Therefore, stereotactic biopsy is usually used in breast imaging to biopsy calcifications. Fluoroscopy sometimes will not be able to locate chest nodules, and CT will be used for guidance. Your radiologist will use the image guidance best suited to biopsy the area in question. top of page This page was reviewed on April, 15, 2022 What kind of biopsy is performed by scraping cells from an oral lesion for further study group of answer choices?Incisional Biopsy: This type of Oral Biopsy is performed only to sample a representative portion of the oral lesion. If the lesion is large or has many differing characteristics, it may require sampling of more than one area. Punch Biopsy: This is done with a punch tool for both incisional and excisional purposes.
What type of biopsy is completed when a surface lesion is scraped to obtain cells?Shave biopsy/punch biopsy.
For a shave biopsy, the doctor removes some tissue by scraping the surface of the skin. In a punch biopsy, they use a small circular instrument to push through the surface of the skin and take a sample of tissue from below the skin's surface. These are used most commonly for a skin biopsy.
What is excisional biopsy of mouth?An excisional biopsy removes the entire lesion and it is both a therapeutic as well as a diagnostic procedure. Excisional biopsies are most commonly used for lesions of 1 cm or less, for even larger benign lesions to avoid multiple surgeries, or when complete removal is possible without significant morbidity.
Who can perform a biopsy of an oral lesion?A surgeon will complete this type of biopsy to obtain a representative sample of the oral lesion. If your oral lesion is large or has differing characteristics, more than one area may need to be sampled.
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