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Diagnostic-Procedures

Biopsy

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 26, 2021.

Your health care provider may recommend a biopsy if an exam or test reveals something suspicious. A common way to diagnose most cancers, a biopsy takes a sample of tissue, fluid or a growth of cells from your body. This sample is then sent to a laboratory to be tested and examined for the presence of cancer or other signs of disease.

Breast biopsies, skin biopsies, bone marrow biopsies and liver biopsies are all common types of biopsies used to determine a cancer diagnosis. Other common biopsy sites include the GI tract, bladder, colon and lymph nodes. A biopsy is the only way to diagnose most cancers. Imaging tests like CT scans and X-rays may be used to help identify abnormal areas, but they can’t differentiate between cancerous and noncancerous cells.

How are biopsies performed?

Biopsies are performed in a number of different ways. Deciding which approach is appropriate for you depends on the size, shape, location and the actual abnormality.  

  • An excisional biopsy involves removing an entire lump or lesion, whereas an incisional biopsy only involves taking a small sample of tissues from a tumor.
  • Many biopsy procedures are categorized by the tool needed to take the sample:
    • A surgical biopsy uses a scalpel.
    • Fine-needle aspiration biopsy uses a thin, hollow needle.
    • A core-needle biopsy uses a larger hollow needle.
    • A punch biopsy uses a circular tool that punches a round hole in the skin.
    • A shave biopsy uses a small blade or razor.
    • An endoscopic biopsy is performed with an endoscope, a thin, flexible tube with a camera attached. Typically, endoscopy is performed in the radiology suite, but if the doctor needs to sample tissue from deep in the body, the procedure may be performed in a surgical suite.
  • Other biopsies are named for the imaging technology used during the procedure. Biopsies may require ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI).
    • CT-guided biopsy combines a CT scan with a biopsy, inserting a needle into the body to obtain a tissue sample. The X-ray is used to provide detailed images of the biopsy area, allowing for more accuracy in placing the needle.

    • MRI-guided breast biopsy uses MRI technology to confirm the location of the tumor, helping the radiologist guide the core needle’s placement into the tumor and remove tissue from the breast.

  • Doctors also refer to biopsies by the part of the body being screened for cancer cells. For example:
    • Bone marrow aspiration and biopsy is used to diagnose hematologic cancers—such as leukemialymphoma and multiple myeloma—that may have been detected by abnormal blood work results. The procedure may also be used for cancers that have spread to bone marrow from another location, like the breast. Bone marrow aspiration and biopsy requires using a needle to remove bone marrow fluid, usually from the hip or breastbone, then examining the sample under a microscope.

    • Sentinel lymph node biopsy helps doctors determine whether the cancer has spread. In this procedure, dye is injected into the tumor. The first lymph node (or nodes) to absorb the dye are considered sentinel, because they are the first to which the cancer is most likely to spread from a primary tumor. The surgeon removes the sentinel lymph nodes, and the pathologist then tests samples for the presence of cancer. If the testing determines that the cancer has spread, more lymph nodes may need to be removed. Sometimes, this biopsy is performed while the primary tumor is being removed. This type of biopsy is commonly performed on breast tumors or melanoma.

What are the risks of undergoing a biopsy?

At Cancer Treatment Centers of America® (CTCA), we understand the anxiety that comes with any type of diagnostic or cancer treatment procedure. Our team of experts takes the time to discuss with patients each procedure, explaining how it’s performed, any risks involved and answering other questions they may have.

Generally speaking, any procedure that involves cutting into the skin comes with some risk. However, biopsies require only small incisions, especially in needle biopsies, so the risks are typically lower than for more invasive procedures. Risks may include:

  • Pain: You may experience some minor pain at the incision site. Contact your doctor if you experience severe pain after your biopsy.
  • Infection: Talk to your doctor if you notice redness, swelling or drainage in the area the biopsy was performed, or if you develop a fever after the procedure. These may be signs of infection.
  • Excessive bleeding: Bleeding, if any, is typically minimal, especially because the incision is small, but in some rare cases, patients may experience heavier bleeding or bleeding that doesn’t stop. Contact your physician if the incision site bleeds for longer than expected or if it does not heal.
  • Allergic reactions: The antibiotic, numbing gel, or bandages used in biopsies may cause allergic reactions to the skin. Talk to your doctor if you notice redness or itching at the biopsy site.

Preparing for your biopsy

Before your biopsy, tell your doctor:

  • If you are pregnant or allergic to latex
  • What medications you’re taking, including over-the-counter drugs
  • If you take any vitamins, supplements or herbal remedies

Depending on the type of biopsy being performed, your doctor may advise you to take additional steps to prepare for your procedure, such as fasting a certain number of hours beforehand or discontinuing medications.

You will also likely be asked to leave jewelry at home and wear loose-fitting, comfortable clothing, or when appropriate, a gown. The procedure may take place in a doctor's office, radiology suite or surgical suite, depending on the type of biopsy being performed.

What happens during the biopsy?

During the procedure, your doctor or surgeon will take a small sample of tissue from your body. To perform this procedure, your doctor will:

  • Place you in a comfortable position that allows access to the part of your body being biopsied
  • Sterilize the area being biopsied and apply a local anesthetic to reduce pain
  • Give you general anesthesia, sedation or relaxation medication intravenously, if needed

When will I know the results?

At CTCA®, your care team will work to deliver results of the pathology report as quickly as possible, so you can make informed decisions about the road ahead. The biopsy results are typically returned in one to three days, depending on the sample and blood tests. Your doctor will thoroughly explain the results to you, and if necessary, recommend follow-up tests or treatments.

If the incision site requires stitches, your care team may have to remove them, usually a week to 10 days after the biopsy.