Biopsy

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What is a biopsy?

The word biopsy is coined from the Greek words ‘bios’ meaning ‘life’, and ‘opsis’ meaning ‘a sight’. When combined, the two words literally mean ‘to view life’.

Medically, a biopsy is a diagnostic technique. A biopsy technique is characterised by the removal of samples of tissue or cells, which are examined analysed in the laboratory by a pathologist.

A biopsy is usually carried out to diagnose cancer or some certain condition. While imaging tests (for instance X-rays, CT scan) are useful in identifying masses or areas of abnormality, they can’t differentiate cancerous cells from non-cancerous cells. Therefore, for most cancers, the only way for a definitive diagnosis is to perform a biopsy procedure to collect samples of cells/tissues for closer examination.

Depending on the aim, a biopsy technique may be excisional or incisional.

• An excisional biopsy technique is when a whole lump or a targeted area is completely surgically removed.
• An incisional biopsy technique, also known as or core biopsy, involves taking just a sample of tissue.

Why is a biopsy done?

The biopsy can be recommended for a number of reasons such as

1. To diagnose tumours and cancers: With the help of a biopsy, the true state of tumours are established and may be graded as cancerous (malignant) or non-cancerous (benign).
2. To grade tumours: Cancer biopsies assist in grading the tumour. That is, the microscopic analysis of the tumour provides useful clues about the nature, rate of growth and aggressiveness of cancer. It is based on this that the cancer is staged. The staging helps to decide the treatment plan and to predict the outcome of the cancer.
3. To diagnose peptic ulcer: A biopsy can help determine ulceration caused by non-steroidal anti-inflammatory drugs.
4. Other uses include

• • Diagnosis of leukaemia.
  • Detection of the effects of drugs, toxins and infections.
  • Diagnosis of liver disease.
  • Infection and autoimmune disorders.
  • Inflammation.

At times, biopsies can also be done on transplanted organs to know if the body is rejecting the organ, or whether the disease that required the transplant in the first place has come resurfaced.

Types of biopsy.

Biopsy procedures are of different types

• Needle biopsy – For this biopsy procedure, a fine needle is used to remove a piece of tissue from the tumour or growth.
• Vacuum assisted biopsy – For this biopsy procedure, a thicker, hollow needle is used to remove cores of tissue with a solo insertion of a vacuum assisted probe.
• Surgical biopsy – For this biopsy procedure, minor surgery is performed. The whole of the tumour, or a small part of it, is cut out and removed for examination. When an entire growth or a suspicious area is removed, this biopsy procedure is called an ‘excisional biopsy’. When only a sample of tissue is cut out, this biopsy procedure is called an ‘incisional biopsy’ or ‘core biopsy’. This procedure is more extensive and may require a hospital stay.
• A punch biopsy – For this biopsy procedure, a special instrument is used to punch a small hole in the skin to obtain a skin sample for investigation of a skin condition.

Preparation for a biopsy.

Biopsies may require a little preparation on the part of the patient, for instance bowel prep, clear liquid diet or nothing by mouth. Certain drugs, such as aspirin or non-steroidal anti-inflammatory medications, may have to be discontinued before a biopsy. However, the doctor will give a detailed instruction on what to do before the procedure.

Biopsy report and analysis.

Biopsy report depends on the type of biopsy. A straightforward report may take between 2 to 3 days, while a complex case may take between 7 to 10 days.

Based on the findings and analysis, a pathologist is able to determine whether or not the tissue removed contains a tumour, and if it does, what type it is – benign (non-cancerous) or malignant (cancerous).

FAQs 

How long does it take to recover from a biopsy procedure?

Recovery period from a biopsy technique depends on the type of biopsy carried out.

• For least invasive biopsy procedure, this requires no recovery time. Return to normal activities are almost immediately after the procedure.
• For a more invasive biopsy procedure, recovery may require a longer time.

Is a biopsy procedure safe? 

A biopsy technique is usually very safe, and it is considered to be of a very low risk procedure. However, as with any skin puncture, there is a little chance of infection.

Accidental injury occasionally occurs and affect nearby organs. For instance, a bowel damage may occur during an abdominal biopsy.

What are the biopsy complications?

Biopsy complications may include 

• The possibility of bleeding.
• Missing the site of the suspected tissue, which may give to a false negative result.
• Not collecting sufficient material, this may lead to a repeat.
• Severe pain, fever and infection.

Is a biopsy procedure painful?

If an anaesthesia is given, there should be no pain during the biopsy procedure. There will only be a slight skin prick during the initial injection.

For a needle biopsy procedure, a pin prick and a sharp pinch will be felt.

Also, depending on the type of biopsy procedure, there may be soreness for a couple of days.

Where are biopsies performed?

Biopsy techniques can be carried on almost any organ. For example, the breast, the kidneys, the liver, the bone marrow, the bone, the skin, the lungs, the lymph nodes, the muscles, the nerves, the testes, the thyroid, the bladder, the heart, the neck, and the prostate, but to mention a few