What you need to know about a biopsy? Common Questions:

You’ve been to the doctor, and you have been told you will be having a biopsy of some sought. I know the doctor has answered most of the questions you have about the procedure.

But you still go to google to find out more answers you did not get from the doctor’s office. You are in the right place.

As a diagnostic radiographer, who specialised in interventional x-ray procedures. I will answer some of the questions I hear from patients who come for biopsies during clinics.

I work and assist radiologists during biopsy procedures. For this article I have based on scientific studies and consulted experts in this area to answer some of your questions.

Happy reading!😀

Have any questions, remarks, or experience to share? Feel free to use the comments section at the end of the article!🙏

Last updated: April 2024. Written by Juliet Semakula, diagnostic radiographer.

Disclaimer: no affiliate links.

Basics!

▶️What is a biopsy in concrete terms?

A biopsy is a medical procedure that involves taking a small sample of body tissue so it can be examined under a microscope.

A tissue sample can be taken from almost anywhere on or in your body, including the skin, organs such as liver, kidney, breast and other structures.

The term biopsy is often used to refer to both the act of taking the sample and the tissue sample itself.

▶️What is the biopsy test for?

Some people wonder if a biopsy is a procedure used to diagnose cancer only.

The answer to this is No!

A biopsy can be used to investigate different  abnormalities, which can be:

🟩Functional – such as kidney or liver problem.

🟩Structural – such as swelling in a particular organ.

When the tissue sample is examined under the microscope, abnormal cells may be identified, which can help to diagnose a specific condition not only cancer.

If a condition has already been diagnosed, a biopsy can also be used to assess its severity such as:

 The degree of inflammation and grade (such as the aggressiveness of  the condition).

This information can be very useful when deciding on the most appropriate treatment, and assessing how well you respond to a particular type of treatment.

It can also be useful in helping to determine your overall diagnosis.

▶️Is a biopsy done only for cancer?

A biopsy is not done only for cancer, most of the patients I see in intervention are always full of fear and panic when they are told they are going to have a biopsy.

This is understood because for some reason when you hear the word biopsy there has been an association to cancer over the years.

Now to answer your question not all biopsies do turn out to be cancer, most of them I have seen end up being non-cancerous.

Am not just giving you hope but it is the truth. but of course, some come out to be cancer.

Let’s hope you are among those who will get a negative result but still whatever the case there is always treatment and proper management.

Some of the conditions where you may need a biopsy to determine the problem.

⏸️Cancer-Some cancers are diagnosed through biopsy samples and other tests.

⏸️Inflammation, in the liver (hepatitis) or kidney (nephritis)

⏸️Infection, in lymph nodes for example tuberculosis

⏸️Various skin conditions

Because many skin lesions and disorders can appear similar, the doctors struggle to diagnose them definitively without obtaining a biopsy. (Greenwood 2022)

⏸️Breast lumps and lymph nodes.

⏸️Thyroid or neck biopsy.

Note! It’s not usually possible to tell whether a lump or growth on your skin or inside your body is cancerous (malignant) or non-cancerous (benign) by clinical examination alone, which is why a biopsy is often required.

 Winkler 2021

▶️Types of biopsies.

There are various types of biopsy that can be used to help identify a wide range of health conditions.

These are some of the biopsies I have seen being done in interventional.

1️⃣A punch biopsy here the doctor will use a special biopsy needle to punch a small hole in the skin to obtain a skin sample to investigate a skin condition.

A needle biopsy is a special hollow needle, guided by X-ray, ultrasound, CT scan or MRI scan, that is used to obtain tissue from an organ or from tissue underneath the skin.

2️⃣An endoscopic biopsy here an endoscope is used to remove tissue, such as from the stomach during a gastroscopy.

3️⃣An excision biopsy here surgery is used to remove a larger section of tissue.

4️⃣Perioperative biopsy – a perioperative biopsy can be carried out during surgery; in certain circumstances, the sample may be tested straightaway to help guide the surgery or further treatment.

▶️Would a doctor say you have cancer or any other condition before biopsy results?

No, a doctor cannot say you have cancer or any other condition before other tests or a biopsy sample is taken  to determine your condition. only results will confirm that.

▶️Can doctors tell if a mass is cancerous without a biopsy?

The short answer is no. While imaging and blood draws can show suspicious areas or levels of something in your body.

 Only removing tissue and studying it is the only way to diagnose cancer 100%.

▶️What should you not do before a biopsy?

You will be given instructions according to the kind of biopsy you will be having by your doctor.

These are some of the instructions given to the patients who come to us. It will be different for every patient based on the kind of biopsy you are having.

✅For some biopsies like liver, you should stop eating a big meal for 6 hours before the biopsy, and water for 2 hours. Still, this will depend on what kind of biopsy you are having.

✅Do not take aspirin or aspirin products before the biopsy. Still depends on so many things consult your doctor.

✅Do not take blood thinning products before the biopsy. Still consult your doctor.

✅Do not take anti-inflammatory products before the biopsy.

✅ Do not take Vitamin E before the biopsy.

This is not medical advice, consult your doctor before the procedure and you will be given instructions according to the kind of biopsy you are having.

▶️How long do I stay in hospital after a biopsy?

Most patients we see in the interventional department are outpatients, usually you can go home after 1 to 4 hours of observation in the hospital.

The local anaesthetic is given to numb the area of the body during the procedure to help relieve pain. For this reason you will not be able to walk or drive straight away.

So you will be required to have bed rest for a few hours as you are being monitored. Unless there are other concerns from your doctor than you will stay a night in hospital for observation.

For procedures carried out under general anaesthetic where you are put to sleep, where you are unaware of the procedure or pain.

In such a situation, depending on your condition, you will have to stay in hospital for a few hours or days after your operation.

▶️How long do you take to recover after having a biopsy?

What do we mean by the word ‘recover’?

Are we talking about how long it takes for you to stop feeling pain?

The truth is most biopsies are straightforward and painless once the anaesthetic starts to work. The whole procedure can take 15 to 30 minutes with no complications or pain.

You may experience a dull ache or some slight discomfort if you have had a sample taken out of a major organ such as the liver, which can be treated by painkillers on the advice of your doctor.

Are we talking about all the potential issues like stitches if you have had a biopsy during an open surgery associated with the procedure to heal?

However, if a cut (incision) is needed to remove a tissue sample for example, during an excision biopsy, stitches may be needed to close the wound, or a dressing may need to be applied.
In such cases you may need to stay in hospital for a few hours or days after the procedure.

This is because you can rest and make sure everything is ok with you before going home.

To be honest most patients I have spoken to after the procedure claim to have not felt any pain during and after.

▶️How long does it take to find out the results from a biopsy? 

Most patients after they have had their biopsy, they are usually anxious wondering when they will be able to receive their results.

I understand that it can be very frustrating not knowing straight away the results from the biopsy.

But even the doctor who has taken the biopsy will find it difficult to give you a very precise idea in days or weeks of the timeline when the results will be ready.

How quickly you get the results of a biopsy will depend on the urgency of your case and your local hospital’s policy.

If you are reading this from another country, please consult your doctor to find out how to receive your results.

It generally often takes a few days to weeks to get your results, but this is difficult to predict, because further tests may be needed after the first examination of the sample.

Sometimes these samples are sent away to a specialised lab to get another specialist opinion.

If a biopsy is carried out during surgery, in some cases a different processing method may be used, known as a frozen section.

This enables the surgeon to get a preliminary result, which can be used to help guide treatment while it’s in progress.

Here in the United Kingdom, you will receive results from your GP, hospital consultant or practice nurse will give you your results and explain what they mean.

If a biopsy comes back inconclusive which sometimes happens, which means it hasn’t produced a definitive result.

 In this case, the biopsy may need to be repeated, or other tests may be required to confirm your diagnosis.

You have come to the end of this article. I think I have answered some of the questions I have always had patients ask about biopsy.

I wish you a good recovery🙋

Do not worry, all biopsies  are not cancerous! Do you have any comments or question? Your comments are welcome.

📚Sources:

Greenwood JD, Merry SP, Boswell CL. Skin Biopsy Techniques. Prim Care. 2022 Mar;49(1):1-22. doi: 10.1016/j.pop.2021.10.001. Epub 2022 Jan 5. PMID: 35125151.

Lidbury JA. Getting the Most Out of Liver Biopsy. Vet Clin North Am Small Anim Pract. 2017 May;47(3):569-583. doi: 10.1016/j.cvsm.2016.11.007. Epub 2017 Jan 9. PMID: 28081862.

Altuwairgi O, Baharoon S, Alkabab Y, Alsafi E, Almoweqel M, A L-Jahdali H. Ultrasound-guided core biopsy in the diagnostic work-up of tuberculous lymphadenitis in Saudi Arabia, refining the diagnostic approach. Case series and review of literature. J Infect Public Health. 2014 Sep-Oct;7(5):371-6. doi: 10.1016/j.jiph.2014.03.002. Epub 2014 Jun 20. PMID: 24954068.

Winkler NS. Ultrasound Guided Core Breast Biopsies. Tech Vasc Interv Radiol. 2021 Sep;24(3):100776. doi: 10.1016/j.tvir.2021.100776. Epub 2021 Oct 2. PMID: 34861968.

Crockford PM, Bain GO. Fine-needle aspiration biospy of the thyroid. Can Med Assoc J. 1974 May 4;110(9):1029-32. PMID: 4406333; PMCID: PMC1947742.

https://www.nhs.uk/conditions/biopsy

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