Definition and Overview

Also known as tissue sampling, biopsy is a diagnostic procedure that involves obtaining a sample of tissue or cells for analysis in the lab to either diagnose a medical condition or to determine the best treatment or therapy option for the patient.

An internist, who can be an oncologist or a kidney expert, may request and/or perform the procedure. The obtained sample is then delivered to the lab where a histologist who specializes in the structures of tissues analyzes the sample. Meanwhile, a pathologist is also needed to determine the cause of the condition, although the doctor who requests for the procedure, may also do it.

Biopsies are often associated with cancer. Cancer can be detected in cells and tissues, wherein the cells form into tumors or masses that latch themselves to the organs. Depending on the biopsy performed, it can determine the “invasiveness of the disease”—that is, whether it has already spread to other areas of the body. This may also be used to rule out the presence of cancer or to determine whether the mass is benign.

However, the term biopsy is very broad, covering any tests on tissues to detect abnormalities including physical differences in size and shape of the sample from that of the general population.

There are many ways to perform a biopsy depending on what type of tissue the doctor needs, the suspected disease, or the result of the initial tests that may have compelled the doctor to request a biopsy in the first place.

Who Should Undergo and Expected Results

An internist or an organ specialist is the best person to determine whether a patient needs a biopsy based on the results of initial examinations that may indicate suspicious abnormalities in the tissues or cells. For example, a woman who has gone through a mammogram that confirms a tumor growth may be asked to proceed with breast biopsy to determine the underlying condition or the cause of the tumor growth.

A biopsy may also be needed to check for other diseases such as cirrhosis of the liver, a condition characterized by severely scarred liver. The changes in the tissue can be detected by a biopsy. A kidney biopsy, on the other hand, is a standard procedure to check if the kidney for transplantation carries any disease. This is a standard procedure to ensure that the recipient will receive a healthy, functional kidney.

Biopsies may also be performed to determine the progression of the disease. Further, it is a common step in genetic testing in which chemicals or other types of agents may be used on the tissue prior to obtaining samples.

The results of the biopsy are typically released after a couple of weeks. However, there are times when they are conducted during a surgical procedure. The sample may be collected prior or during the procedure. It will then be immediately delivered to the lab where specialists analyze the sample and provide their initial diagnosis or report. The surgeon can then use the data to plan the surgery properly. A more comprehensive biopsy is performed a few days or weeks after.

A biopsy can be invasive, in which case, the recovery period may be longer. The doctor may provide certain medications to speed up the healing process or to avoid as much risks and complications as possible.

How Does the Procedure Work?

A biopsy is often performed using a needle; its thickness and length will depend on the site where the tissue is going to be obtained. For example, if it is going to be a bone marrow biopsy, a long needle will be needed to draw the sample.

It may also be carried out with other instruments such as probes or scopes that can be used to guide the doctor in extracting the sample. In a Pap smear, an instrument is utilized to scrape the cervix for tissue samples.

Biopsies can also be minimally invasive or invasive. If the biopsy is performed during a surgery, it is called an open biopsy. If a small cut is needed, it is called a closed biopsy. The more invasive the biopsy is going to be, the higher the chance the doctor is going to require either local or general anesthesia to minimize bleeding and pain, as well as improve the comfort of the patient.

Usually, there is no special preparation needed before the biopsy, although anything that may affect the tissue sample such as medications or an already existing disease should be shared with the doctor. If a patient is taking certain drugs, he or she may be asked to stop the intake a couple of days before the biopsy.

Possible Risks and Complications

Two of the most common risks or complications of biopsies are infection and bleeding. It is normal for biopsies to cause minimal bleeding, especially if it is performed with a cut. However, as soon as the incision is closed, the bleeding should also stop. The bigger danger is internal bleeding, which may happen if the instrument used to collect the sample or guide the device for sample collection injures a tissue or disrupts a blood vessel. A person who develops nausea, vomiting, high fever, and abnormal or excruciating pain particularly at the tissue site of the biopsy, should call a health provider immediately.

Infection may also arise due to incisions from the biopsy. Medications may be provided to prevent it.

References:

  • National Cancer Institute: "Dictionary of Cancer Terms."
  • Zuber, T. American Family Physician, March 15, 2002.
  • WebMD Medical Reference: "Breast Biopsy."
  • National Kidney and Urologic Diseases Information Clearinghouse: "Kidney Biopsy."
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