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What is a biopsy?

A biopsy is a medical procedure involving the collection and microscopic examination of a small tissue or cell sample from body to analyse it for the presence of any disease or damage. Some other tests may also be performed on this sample to identify the exact cause of symptoms experienced by an individual. A biopsy can be performed on all parts of body, including skin surface, organs and other structures. It can be used for diagnosing many conditions but is most commonly used to detect the presence of cancerous cells.

  1. Why is a Biopsy performed?
  2. How do you prepare for a Biopsy?
  3. How is a Biopsy performed?
  4. What do Biopsy results mean?

A biopsy is performed to investigate the presence of damage, disease or abnormalities in body. It can detect both functional abnormalities, such as liver and kidney diseases, as well as structural abnormalities such as swelling. A biopsy is generally performed for the following reasons:

  • Diagnosis of a condition: A detailed information of the sample is obtained using a microscope, which aids in accurate diagnosis of the underlying disease that manifests itself as an abnormality in tissue or cell sample
  • Severity of a condition: Severity of a disease, which is previously diagnosed, can also be determined with a biopsy, eg, severity of cancer and degree of inflammation. This information can help in deciding the correct therapeutic measures for treating diseases
  • Assessment of the current status of a disease
  • To monitor the effectiveness of the applied therapy.

A biopsy is useful in the diagnosis of numerous conditions, such as inflammation of liver and kidney; cancer; skin diseases; and infections. It also helps to classify cancerous and noncancerous lumps, which is often challenging on the basis of a clinical examination alone.

No special preparation is needed before going for a biopsy.

Provide the necessary information regarding any medicine that you are taking before scheduling a biopsy. Keep your doctor informed about any prescription or over-the-counter medications you are taking including any nutritional and herbal supplements.

Some of the medicines that need to be particularly mentioned to the doctor before a biopsy include non-steroidal anti-inflammatory drugs and blood thinners, such as warfarin, dabigatran, apixaban, clopidogrel and rivaroxaban. Also, he/she should be informed about the details of any recent illnesses and any medical conditions in the past.

Procedure of biopsy depends on the tissue sample needed for testing. Computed tomography or magnetic resonance imaging scan is generally needed/done prior to biopsy to determine the nature of the problem. Many types of biopsies exist, which help in diagnosing different conditions. Some of these include:

  • Endoscopic biopsy: An endoscope (an illuminated optical and tubular instrument for observing inside the body) is used to remove tissue, eg, a stomach tissue during gastroscopy
  • Punch biopsy: A unique instrument is used in this biopsy. It punches a hole in the skin and helps to obtain a skin tissue sample for analysis
  • Excision biopsy: In this type of biopsy, a surgical procedure is performed to obtain a large tissue sample
  • Perioperative biopsy: A sample obtained from surgery is used for analysis, which helps in deciding further treatment
  • Needle biopsy: A hollow needle is used to obtain tissue from an organ or from under the skin

In case of needle biopsy, a sharp pinch and discomfort are felt in the area of tissue collection. Most biopsies involve local anaesthesia, which lowers the intensity of pain, so an overnight stay in hospital is not needed. Some biopsies that require more extensive excision use general anaesthesia to reduce the severity of pain during the procedure. A hospital stay is required when general anaesthesia is used for biopsy. A sore feeling may be present in the area of tissue collection in the first few days after the procedure. It is generally overcome by a pain-relieving medication.

A biopsy may involve stitches or dressing of the area from where tissue is collected. It is also associated with a risk of bleeding, infection and accidental injury to the adjacent tissue and structures.

Biopsy is generally used to determine the presence or absence of cancer. Results of a biopsy are often available in a few days and indicate the following:

  • When the tested tissues are found to be in proper shape and size, the test results are said to be normal.
  • When the tested tissue is found to have an unusual shape, size, structure and condition, further tests may be recommended

In addition to biopsy, other tests may also be prescribed to identify the exact underlying cause. Occasionally, results of a biopsy are inconclusive and it needs to be repeated to determine the underlying condition.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. This information is purely from an educational point of view and is in no way a substitute for medical advice from a qualified doctor. 

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References

  1. Society of Interventional Radiology (SIR); Interventional radiology (IR): patient center
  2. National Health Service [internet]. UK: Biopsy
  3. American Cancer Society [internet]. Atlanta (GA), USA: Testing Biopsy and Cytology Specimens for Cancer
  4. American College of Radiology (ACR), the Society of Interventional Radiology (SIR), and the Society for Pediatric Radiology. ACR-SIR-SPR practice parameter for the performance of image-guided percutaneous needle biopsy (PNB) . Amended 2014 (Resolution 39)
  5. Chernecky CC, Berger BJ. Biopsy, site-specific - specimen. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures, 6th Edition St Louis, MO: Elsevier Saunders; 2013:199-202.