Types of Biopsy

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What is a Biopsy?

In order to confirm cancer, a biopsy test is performed. Other tests may suggest cancer. But only a biopsy can make a cancer diagnosis. Your doctor will remove a tissue sample from the suspected tumor and study it under a microscope. During the biopsy, your doctor will look for cancer cells in the tissue. 

The removal of tissue or cells for medical examination is called a biopsy. The biopsy is done to analyse if the abnormalities in your body are caused by cancer or by other conditions. There are different types of biopsies possible, depending on the location of your tumour. Some biopsies can be done with local anaesthesia and others may need sedation that puts you completely asleep during the procedure.

What are the Types of Biopsy?

  • Image-guided biopsy: If the tumour is located deep inside your body and your doctor cannot physically examine the tumour in areas like the liver, lung or prostate, he may use an imaging technique to guide a needle to the location of the tumour. This imaging technique may use ultrasound, X-ray, CT scan, MRI scan (magnetic resonance imaging) or fluoroscopy to guide the needle to the site of cancer. 
  • Fine needle biopsy: During the fine needle biopsy, a long thin needle is inserted into the suspected area. A syringe is used to draw out fluid and cells for analysis and this is a minimally invasive procedure. This type of biopsy is often used on tumours that your doctor can feel through your skin, such as enlarged lymph nodes.
  • Core needle biopsy: During the core needle biopsy, a larger needle with a cutting tip is inserted into the suspected area removing a larger sample of tissue. The core needle biopsy is also minimally invasive.
  • Vacuum-assisted biopsy: Your doctor may use a suction device to collect a tissue sample using a special needle. During a vacuum-assisted biopsy, a suction device is used to collect a tissue sample using a special needle. This test is usually done in the outpatient department of a hospital and is common in breast cancer diagnoses. It is not usually painful and is performed under local anaesthesia.
  • Excisional biopsy: During an excisional biopsy, the doctor removes an entire lump or an entire area of abnormal skin for tests. You will also receive stitches to close the biopsy site.
  • Shave biopsy: Your doctor may remove a small tissue sample from the surface of the skin.
  • Punch biopsy: Sometimes, your doctor may prefer to ‘punch’ a sample of tissue from below the skin surface using a circular tool.
  • Laparoscopic biopsy: To see abnormal tissues in the abdomen, your doctor may insert a thin tube with a video camera at its mouth through a small incision. He may then remove a small sample using a fine needle.
  • Endoscopic biopsy: Similar to a laparoscopic biopsy, your doctor may use a thin endoscope tube through your mouth or through a tiny incision. This type of biopsy is used for areas in the bladder, joints, GI tract, and abdomen. A small sample of tissue may be removed using forceps that are a part of the endoscope. Depending on the type of endoscopic biopsy, you will receive a sedative or anaesthetic before the procedure.
  • Bone Marrow Biopsy and aspiration: During a bone marrow biopsy, your doctor draws a sample of the bone marrow from your hip bone using a long needle. In order to take solid and liquid samples of suspected bone marrow, your doctor may use two needles for biopsy and aspiration. These two procedures are often performed at the same time. Bone marrow biopsy is used to diagnose both non-cancerous and cancerous blood disease which also includes leukaemia, lymphoma and multiple myeloma. You will receive local anaesthesia before a bone marrow biopsy in order to minimize discomfort during this procedure.
  • Liquid biopsy: Liquid biopsy is used to test for blood cancer. A routine blood test will be analyzed in a special way for diagnosis or to check the progress of a tumour or the success of treatment. Liquid biopsy is relatively new and not widely used for cancers yet.

What are the Common Biopsy sites?

  • Bone marrow 
  • Brain 
  • Breast 
  • Gastrointestinal tract (stomach and intestines) 
  • Liver 
  • Lung 
  • Lymph nodes 
  • Skin 
  • Thyroid 

After a biopsy test, the tissue specimen is sent to the pathology lab to be examined and analyzed.

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Frequently Asked Questions:

Is a Biopsy painful?

You may feel the pain at the area of the biopsy for a few days. If you have significant pain from the biopsy, your doctor can prescribe pain relief medication.

Can I go to work after a Biopsy?

After a biopsy walking is possible but it should be minimised. Activity should gradually be resumed following the procedure. It is advisable to take one or two days off from work after the procedure.

How do you prepare for a Biopsy?

If you are preparing for a biopsy, you can ask your health care provider if you need to stop taking any medications before the procedure. You will be instructed not to eat or drink for eight hours before your biopsy. However, you will be allowed to take your routine medications with sips of water.

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