All that you need to know about biopsies

What is a Biopsy?

A biopsy is a medical procedure in which a sample of tissue, affected by a medical condition, is removed from the body and examined under a microscope to determine the nature of the disorder. Both the procedure and the tissue sample removed are called a biopsy.

Why is a Biopsy required?

Biopsies are performed for various reasons:

1. To confirm or rule out cancers: Visual examinations, physical examinations or CT scans can confirm if there is an abnormal growth present in the body. However, that is not enough to confirm that the tissue is cancerous or non-cancerous. A biopsy is often required to confirm the diagnosis.
2. To confirm or rule out a host of other diseases/conditions:

• Hepatitis, which is an inflammation of the liver.
• Endometriosis, where cells that are usually present in the inner lining of the womb (endometrium) are found elsewhere in the body.
• Peptic ulcers that affect the digestive system.
• Kidney disease
• Various other disorders or infections

1. To gauge the extent of the condition: Some of the conditions listed above can be confirmed through other tests. But only a biopsy can pinpoint the extent. Examples include inflammation of the liver.
2. During an autopsy: If the cause of death is not clear, the coroner may choose to do a biopsy on one or more parts of the body.
3. During surgery: Peri-operative biopsy is when the surgeon does a quick biopsy of the suspect tissue to determine the course of the operation.

How is a Biopsy done?

Various techniques and procedures may be used:

1. Bone Marrow Biopsy: Although this technique is similar to needle biopsy described below, the length and type of needle are different. As the name implies, a small quantity of bone marrow is extracted and examined for blood disorders.
2. Needle Biopsy: Here a thin needle is inserted into the affected tissue and a small sample removed. This is used to confirm or rule out cancers or other conditions in the liver, kidney, prostate and breast. The technique used in needle biopsy can vary so the procedures could be fine-needle, core-needle, image-guided and vacuum-assisted needle biopsies.
3. Endoscopic Biopsy: In this a catheter, with a camera and a cutting tool at the tip, is inserted into the body and guided to the location of the suspect tissue. The cutting tool at the end then extracts a sample after which the endoscope is pulled out.
4. Skin Biopsy: Here, the conditions manifest themselves on the outer surface of the skin, so a sample can be extracted more easily. Various techniques such as shave biopsy (scraping a part of the tissue), punch biopsy (a punch like device cuts a circular hole on the skin), incisional (a scalpel is used to cut out a small skin sample) and excisional (a scalpel is used to extract the entire area of suspect tissue).
5. Surgical Biopsy: If the tissue is embedded deep in the body, surgery may be required to extract a small sample of tissue. Examples include breast cancer, abdominal cancer, etc.

Who does a Biopsy?

The biopsy is examined by a Pathologist or a specialist in this area called a Histopathologist.

Before and during the Biopsy

Depending on the type of biopsy being planned for you and the disease or condition in question, there may be different dos and don’ts for the patient. This includes a bowel prep, liquid food, fasting before the procedure etc. The doctor will also ask you about medications you are taking or taken in the recent past. This helps rule out allergic reactions or other consequences. Some drugs like aspirin and NSAIDs may be temporarily discontinued.

Other than the surgical biopsy which is conducted in an operating room under general, regional or local anaesthesia, all other biopsies are out-patient procedures conducted at the doctor’s office or the pathology lab. A mild sedative may be given to numb the pain and reduce discomfort.

After the Biopsy

 After the biopsy, you may experience a mild pain in the area which can be reduced by pain-killers. Depending on the condition being tested for, the biopsy results may take 1 to 2 weeks to arrive.

Conclusion

Biopsies are perfectly safe procedures with very little pain or discomfort associated with them. Biopsy is a very reliable and indispensable tool in the diagnosis and treatment of disease.

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Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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