Biopsy

Definition

A biopsy is the removal of a small piece of tissue for laboratory examination.

Alternative Names

Tissue sampling

How the Test is Performed

There are several different types of biopsies.

A needle biopsy is done using local anesthesia. There are two types.

• Fine needle aspiration uses a small needle attached to a syringe. Very small amounts of tissue cells are removed.
• Core biopsy removes slivers of tissue using a hollow needle attached to a spring-loaded device.

With either type of needle biopsy, the needle is passed several times through the tissue being examined. The doctor uses the needle to remove the tissue sample. Needle biopsies are often done using CT scan, MRI, mammogram, or ultrasound. These imaging tools help guide the doctor to the right area.

An open biopsy is surgery that uses local or general anesthesia. This means you are relaxed (sedated) or asleep and pain free during the procedure. It is done in a hospital operating room. The surgeon makes a cut into the affected area, and the tissue is removed.

A laparoscopic biopsy uses much smaller surgical cuts than an open biopsy. A camera-like instrument (laparoscope) and tools can be inserted. The laparoscope helps guide the surgeon to the right place to take the sample.

A skin lesion biopsy is done when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases.

How to Prepare for the Test

Before scheduling the biopsy, tell your health care provider about any medicines you are taking, including herbs and supplements. You may be asked to stop taking some for a while. These include blood thinners such as:

• NSAIDs (aspirin, ibuprofen)
• Clopidogrel (Plavix)
• Warfarin (Coumadin)
• Dabigatran (Pradaxa)
• Rivaroxaban (Xarelto)
• Apixaban (Eliquis)

Do not stop or change your medicines without first talking to your provider.

How the Test will Feel

With a needle biopsy, you may feel a small sharp pinch at the site of the biopsy. Local anesthesia is injected to lessen the pain.

In an open or laparoscopic biopsy, general anesthesia is often used so that you will be pain free.

Why the Test is Performed

A biopsy is most often done to examine tissue for disease.

Normal Results

The tissue removed is normal.

What Abnormal Results Mean

An abnormal biopsy means that the tissue or cells have an unusual structure, shape, size, or condition.

This may mean you have a disease, such as cancer, but it depends on your biopsy.

Risks

Risks of a biopsy include:

• Bleeding
• Infection

Considerations

There are many different types of biopsies and not all are done with a needle or surgery. Ask your provider for more information about the specific type of biopsy you are having.

References

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). Revised 2018 (Resolution 14). www.acr.org/-/media/ACR/Files/Practice-Parameters/PNB.pdf. Accessed November 1, 2022.

Chernecky CC, Berger BJ. Biopsy, site-specific - specimen. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:199-202.

Kessel D, Robertson I. Achieving tissue diagnosis. In: Kessel D, Robertson I, eds. Interventional Radiology: A Survival Guide. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 38.

Olbricht S. Biopsy techniques and basic excisions. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 146.