A biopsy is a diagnostic medical procedure in which your doctor takes a tissue sample from a suspicious area. This sample is then sent to a laboratory for evaluation, usually under a microscope. Tissue samples can be taken from most parts of the body during biopsy procedures. 

A biopsy is used to make a definite diagnosis or rule out a specific health condition based on the presence or absence of abnormal cells in the small tissue sample. This allows doctors to plan further treatment based on the biopsy results. 

While biopsies are commonly done when a healthcare provider suspects cancer, they may also be done for autoimmune, infectious, and inflammatory conditions. For instance, your doctor may suggest you have a biopsy performed to diagnose a condition of the nerves or muscles with a nerve biopsy or muscle biopsy, respectively.

Please continue reading to find out what to expect when a tissue sample is taken for biopsy.

What are the different types of biopsy procedures?

The type of biopsy done to collect cells depends on the area of the body where the suspected tumor or lump is present. Most biopsies are done in a doctor’s office, but some may need to be performed in a surgical setting. Some of the common types of biopsy procedures are briefly described below.

Bone Marrow Biopsy 

The bone marrow is a spongy area present inside some large bones where blood cells are manufactured. A bone marrow aspiration is done to diagnose cancer (for example, leukemia or lymphoma) as well as non-cancerous conditions like aplastic anemia. During the procedure, the doctor draws a tissue sample from the hip bone using a long needle. The procedure is done with a local anesthetic to minimize discomfort. Note: A bone biopsy involves taking a sample of the outer layers of bone to detect cancer cells and is different from a bone marrow biopsy.

Endoscopic Biopsy 

During an endoscopic biopsy, doctors insert a thin, flexible tube called an endoscope into an orifice in the body such as the mouth (upper endoscopy), airways (bronchoscopy), urinary bladder (cystoscopy), or rectum (colonoscopy) to collect tissue samples. 

Needle Biopsy

This is a biopsy procedure in which a long, thin needle is inserted through the skin in an area of concern. There are different types of needle biopsies, such as a fine needle aspiration biopsy done with a long, thin needle; a core needle biopsy done with a thicker needle that has a cutting edge; a vacuum-assisted biopsy done to obtain a larger tissue sample; or an image-guided biopsy done using imaging tests like CT scan, MRI, or ultrasound to guide the needle. A stereotactic biopsy uses 3D images to guide the sample collection and is commonly used to perform a brain biopsy for a suspected brain tumor or a breast biopsy of a suspicious breast lump.

Skin Biopsy 

This type of biopsy is done to diagnose skin cancers. It is usually done using local anesthesia. There are different types of skin biopsies, such as:

• A shave biopsy done using a razor-like tool to obtain cells from the skin’s surface.
• A punch biopsy done using a circular tool to obtain tissue samples from the deeper skin layers.
• An incisional biopsy is when a cut is made with a scalpel to remove a small piece of skin (the incision may be closed with stitches).
• An excisional biopsy is in which an entire suspicious lesion, such as a mole, is removed.

Surgical Biopsy

Doctors may recommend you have a surgical biopsy procedure performed if the area of concern is not accessible with other methods like a fine needle biopsy or if another type of biopsy has yielded inconclusive results. A surgical biopsy involves making an incision (cut) in the skin to take a tissue sample of suspicious cells. It can be a laparoscopic biopsy done using small incisions or an open surgery for easier access to the suspicious tissue. Examples of surgical biopsies include breast biopsies to evaluate suspicious breast lumps and surgery to remove biopsy tissue from lymph nodes for a possible diagnosis of lymphoma. 

Is fasting required for a biopsy?

Fasting is not required for most types of biopsies. However, it may be necessary before a surgical biopsy. In general, there is very little preparation required before a biopsy. Your doctor may ask you to discontinue blood thinners for a few days before your biopsy.

How long does a biopsy procedure take?

The time taken for a biopsy depends on the biopsy site. Generally speaking, biopsy procedures are fairly quick and take around 15 to 30 minutes to perform. They are typically outpatient procedures. However, a biopsy may require an overnight hospital stay when the tissue is taken from an internal organ (for example, a liver biopsy or kidney biopsy done using open surgery), or the sample of tissue is taken under general anesthesia, or you have a perioperative biopsy around the time of a planned surgery.

What results to expect from a biopsy?

Biopsy results can tell you whether you have cancer or not. If it is cancer, the results can tell you where it originated (the type of cancer) and how aggressive it is (cancer stage). 

Note that a biopsy may be performed to diagnose conditions other than cancer, such as peptic ulcer, hepatitis, kidney disease, endometriosis, infections, and others. 

Your doctor will correlate the results of your biopsy with your medical history, physical exam, and results of blood tests and imaging tests to give you a diagnosis and plan treatment.

Can a doctor tell if a biopsy is cancer?

The doctor performing your needle or bone marrow biopsy cannot tell if it is cancer. A pathologist will need to look at the tissue sample under the microscope and run other tests to see if it is cancer or something else based on the presence or absence of cancerous cells. 

How long do biopsy results take?

Results take 1-2 days for most biopsies. However, in more complex cases, the results may take longer if other tests need to be done on the tissue sample. If your biopsy results take longer than usual, it does not necessarily mean it is cancer. It simply means your case is more complex, and your doctors need to do further testing to confirm the results.

References:

1. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/biopsy/art-20043922