Biopsy

What is a biopsy?

A biopsy is one of the ways healthcare providers determine what’s going on in your body. In a biopsy, a provider removes samples of your tissue, cells or fluids so a medical pathologist can examine them for signs of disease. Providers may recommend biopsies to diagnose or monitor medical conditions or to plan treatment.

You may hear the term “biopsy” and think “cancer,” but providers do biopsies to diagnose many medical conditions, like:

• Inflammatory disorders, such as in your kidney (nephritis) or liver (hepatitis).
• Infections, like tuberculosis.
• Immune disorders, such as chronic pancreatitis.
• Peptic ulcer disease.
• Endometriosis.

Types of biopsies

All biopsies are procedures to obtain samples of tissue and fluid, but they’re done in different ways. Healthcare providers may do biopsies in medical offices or operating rooms. Biopsy types include:

• Bone marrow biopsy: Providers use a special biopsy needle and syringe to obtain a small sample of bone marrow. They do bone marrow biopsies to diagnose blood cancers, blood disorders and other diseases.
• Cone biopsy: Also known as conization or cold knife biopsy, providers do cone biopsies to remove abnormal tissue from your cervix. Cone biopsies may detect cervical cancer or cervical dysplasia that could lead to cancer.
• Excisional biopsy or incisional biopsies: In these procedures, providers make incisions or cuts in your body to remove tissue from inside your body. Excisional biopsies involve removing entire lumps or suspicious areas. Incisional biopsies involve taking tissue samples of lumps or suspicious areas.
• Liquid biopsy: This blood test detects signs of cancerous cells or cancer cell DNA.
• Needle biopsy: Providers use needle biopsies to extract cells, fluid or tissues. Your provider may order a needle biopsy if they feel an unusual lump or bump on your body or imaging tests detect potential issues.
• Punch biopsy: Providers use a special device to remove tissue that may be cancerous. Providers use a special device that punches a hole in your skin’s surface.
• Sentinel node biopsy: Providers do this procedure to see if cancer cells have spread from an original tumor.
• Shave biopsy: Providers use a razor to scrape up a small sample of skin cells to detect skin cancer.

What happens before a biopsy?

Your healthcare provider understands why you may be anxious about having a biopsy. They’ll take time to explain the procedure they’ll use, including whether you’ll be awake or under anesthesia. They’ll also review the following information so they know:

• What medications you’re taking, including over-the-counter medications, prescription medications, vitamins and herbal supplements.
• Whether you have allergies, including being allergic to latex. Providers typically wear latex gloves when they perform biopsies.
• Your current health. Your provider will know about the medical issues that require biopsy and any other medical conditions, but they may ask if you have new issues. For example, they may ask about viral infections such as colds or flu.
• If you might be pregnant.

Your provider will also let you know if you’ll need to:

• Stop eating or drinking fluids before your biopsy.
• Temporarily stop taking certain medications, such as aspirin or blood thinners.
• Arrange for a ride home after your biopsy.
• Need someone to stay with you for a few hours while you recover.

Finally, your provider will explain what kind of anesthesia they’ll use so you don’t experience pain during the procedure:

• Local anesthesia, which numbs a small section of your body.
• Regional anesthesia, which blocks pain in a larger area of your body.
• General anesthesia, which makes you unconscious and unable to feel pain.

What happens during a biopsy?

There are different ways to do biopsies. The kind of biopsy you’ll have depends on the location of the tissue or fluid your provider wants to examine. Some common biopsies are:

• Breast biopsy.
• Prostate biopsy, including MRI-guided prostate biopsy.
• Endometrial biopsy to detect issues with the lining of your uterus (endometrium).
• Liver biopsy.
• Heart biopsy after heart transplantation.
• Kidney biopsy.
• Skin biopsy.

What happens after a biopsy?

That depends on the anesthesia used and if there were complications. In general, people who received local anesthesia can go home after the procedure. People who had general anesthesia typically have an overnight hospital stay.

Do biopsies hurt?

If you receive anesthesia, the procedures shouldn’t hurt. You may have some post-procedure pain. If you do, let your provider know. They’ll recommend pain medication.

What are possible biopsy complications?

Biopsy complications are rare, but they can happen. Depending on the biopsy procedure, complications may include:

• Excessive bleeding.
• Infection.
• Scarring. You may have a small scar at the biopsy site if your provider used a scalpel or other sharp instrument to obtain tissue samples.

Contact your provider if:

• The biopsy site won’t stop bleeding.
• The site looks red, and/or is tender to your touch, swollen or oozing. These may be symptoms of an infection.
• You have a fever.

When would I know biopsy results?

Waiting for results may be the hardest part of having a biopsy. Your healthcare provider will explain how and when you’ll receive results. Biopsy results may be available within a few hours, a few days or more than a week. Follow up with your provider if you haven’t received the results when you expected.

What happens if my biopsy results show there’s something wrong?

Your healthcare provider will explain test results that detect issues, such as cells that don’t look like normal cells. They’ll also explain the next steps, whether that’s additional tests or planning treatment.

Are biopsy results always accurate?

Biopsies are a very accurate way to detect abnormal cells or other changes in your body that may be signs of issues. That said, studies suggest false-negative results do happen. A false-negative result means you have cancer or another illness that a biopsy didn’t detect. False-negative rates vary depending on the type of cancer or medical condition. If you’re having a biopsy, ask your provider about false-negative rates for that type of biopsy.