Biopsy

A biopsy is the removal of a tissue sample for microscopic examination by a pathologist. It is the definitive method for diagnosing cancer and many other conditions. Types include needle biopsy (fine-needle aspiration, core needle), incisional, excisional, and endoscopic biopsy.

Biopsies are performed when imaging or clinical findings suggest cancer, infection, autoimmune disease, or other conditions requiring tissue diagnosis. They determine whether a mass is benign or malignant, identify the type and grade of cancer, and guide treatment decisions.

Preparation varies by biopsy type. Inform your doctor of blood-thinning medications. Blood tests may be ordered. For image-guided biopsies, fasting may be required. Local anesthesia is used for most biopsies; some require sedation or general anesthesia.

Needle biopsies use a thin or core needle guided by imaging (ultrasound, CT, or MRI) to extract tissue. Incisional biopsies remove a portion of the abnormal area. Excisional biopsies remove the entire lesion. Most biopsies take 15-60 minutes.

Recovery depends on biopsy type. Needle biopsies: resume normal activities same day with a bandage. Surgical biopsies: rest for 1-2 days, avoid strenuous activity for 1-2 weeks. Keep the site clean and dry. Watch for signs of infection.

Risks include bleeding, bruising, infection, pain at the biopsy site, and rarely, damage to nearby structures. Needle track seeding (cancer spreading along the needle path) is extremely rare.

In some cases, imaging alone (MRI, PET/CT) may provide enough information for diagnosis. Liquid biopsies (blood tests for circulating tumor DNA) are emerging but do not yet replace tissue biopsy for most cancers.

Covered by insurance when medically necessary. The cost depends on the type and location of the biopsy, whether imaging guidance is used, and pathology fees.