Biopsy: What It Is and Why It Is Ordered

A referral for a biopsy is almost always frightening: the word "cancer" has not yet been spoken, but anxiety is already present. Let us calmly explain what this test is, how it is performed, and what can be understood from the report.

What a biopsy is

A biopsy is the removal of a small sample of cells or tissue during life for examination. The term was introduced by the French dermatologist Ernest Besnier in 1879. The material (biopsy specimen) is sent to a laboratory: a pathologist examines it under a microscope and describes the cellular composition. A biopsy can be performed on any part of the body.

A referral is given by a family doctor or a specialist.

Why a biopsy is performed in oncology

In oncology, a biopsy is a mandatory way to confirm the diagnosis. Tissue examination allows determining the cellular composition, and in most cases only a biopsy can reliably show whether a suspicious area is cancer.

The second purpose is choosing the treatment strategy: cancer treatment involves traumatic surgery, radiation therapy, and toxic chemotherapy, and it cannot be started without histological or cytological confirmation.

A biopsy is also ordered outside oncology: in gastroenterology, gynecology, and for liver and kidney diseases.

Types of biopsy and methods of tissue sampling

• excisional — the formation is removed entirely; incisional — a part or area of the affected organ is taken;
• core needle biopsy and core biopsy — a column of dense tissue is taken with a hollow tube with a sharp edge;
• fine-needle aspiration — material is obtained with a needle and syringe; the method is suitable for both cysts and dense tumors;
• endoscopic — tissue is taken through a tube with a camera inside;
• forceps, scraping, and loop — options for skin, ENT practice, and gynecology.

By accuracy of targeting, a distinction is made between classical and targeted biopsy: under ultrasound, X-ray, or stereotactic guidance. In men, a common option is prostate biopsy under ultrasound or MRI guidance.

How a biopsy is performed: ultrasound guidance and anesthesia

The procedure usually takes place in a hospital. The doctor says in advance whether preparation is needed and asks about medications: some are discontinued briefly. If general anesthesia is planned, one must not eat or drink before the procedure.

Most often local anesthesia is used: the area loses sensation, the person is awake and feels no pain. Additionally, a medication to help relax may be given. Some biopsies are done under general anesthesia, when the person is asleep. A biopsy may be performed under ultrasound guidance — this is one type of targeted biopsy.

The time depends on the type of procedure: some take less than 30 minutes, others longer. Patients are usually discharged home the same day, with instructions on caring for the dressing or sutures. A biopsy is considered a common and very safe procedure, but pain and discomfort, infection at the sampling site, internal bleeding, and after uterine or cervical biopsy — cramps and light bloody discharge — are possible. If after the procedure pain increases, fever rises, blood or fluid oozes from the sampling site, or the area is swollen or red — contact your attending physician or clinic immediately.

A biopsy by itself is not a reason to call an ambulance; 103/112 — if the condition sharply worsens, the person loses consciousness, or severe bleeding begins that does not stop.

Can a biopsy provoke tumor growth

The concern that a needle "spreads" tumor cells is familiar to many. In patient information materials, biopsy is described as a common and safe procedure, and acceleration of tumor growth is not mentioned among its complications. The logic is simple: without an accurate cellular diagnosis, it is impossible either to confirm the disease or to choose treatment, so refusing a biopsy delays help rather than protecting from it.

What the result shows and when to expect it

Histological examination is the study of tissue under a microscope after special processing and staining; cytological examination is the study of individual cells. The report describes which cells are found and what is happening in the tissue, and on its basis a clinical diagnosis is formed. During surgery, a frozen section examination is sometimes done so the surgeon immediately understands what is being dealt with and determines the extent of intervention.

The result is usually ready in a few weeks; timelines vary by hospital and depend on the reason for referral. If nothing has been reported after several weeks, the person contacts the doctor who referred them for the biopsy or the clinic. Sometimes a repeat biopsy or other examinations are needed. It is reasonable to discuss unclear words in the report with the attending physician.

This text is for reference: it does not replace a doctor's consultation and does not answer questions about your specific case.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer