Atrium Health Navicent Specialty Center

Biopsy Procedures

If a physician suspects that a patient has cancer, then a biopsy procedure is usually the next step. An oncology surgery specialist usually performs biopsy procedures. The oncology surgery specialist will remove a section of cells or a piece of tissue from the suspected tumor in the patient's body. This sample is then sent to a laboratory where it is analyzed to determine if cancer is present and what type of cancer it is. There are several different types of biopsy procedures. Keep reading to learn more about how a biopsy is done.

Bone Marrow Biopsy Procedures

If the doctor believes that the patient has a blood cancer or those they cancer has spread to the bone marrow, and then they may order a bone marrow biopsy procedure. Bone marrow is composed of a spongy material that is found inside the bone. Bone marrow biopsy procedures are designed to figure out if there is something abnormal occurring inside the bone marrow.

During a bone marrow biopsy procedure, the oncology surgery specialist will insert a long needle into the hipbone to collect a sample of the bone marrow. In rare cases, the sample may be taken from other large bones in the body. The sample will then be sent to the lab for analysis.

Needle Biopsy Procedures

A bone marrow biopsy is not the only biopsy procedure that involves a needle. Many skin tumors, breast tumors and other tumors that can be felt as a lump through the skin will be biopsied with a needle. The physician inserts a long needle into the suspected tumor to collect a tissue sample.

Needle biopsy procedures are also used for suspected tumors that cannot be felt through the skin. When this technique is needed, the oncology surgical specialist will use an X-ray, CT scan or another similar imaging method to guide the needle into the site of the suspected tumor.

There are three types of needle biopsy procedures:

• The simplest is a fine-needle aspiration. This involves a small needle that collects fluid and a small amount of cells.
• The next is core needle biopsy. This technique uses a larger needle that has a cutting edge to extract a small sample of tissue from the suspected tumor.
• The third type of needle biopsy procedure is the vacuum-assisted biopsy, where the physician will use vacuum suction to increase the amount of fluid that is collected through the needle. This is the most powerful of the needle biopsy procedures, and it is often used to help prevent multiple needle sticks from becoming necessary.

Endoscopic Biopsy Procedures

Another common biopsy procedure is the endoscopic biopsy procedure. An endoscope is a thin, highly flexible tube that has a light and a camera on the end of it. During endoscopic biopsy procedures, the endoscope is inserted into a hole in the body and guided by the physician to the site of the suspected tumor. A tissue sample is then harvested. The endoscope will be inserted into a bodily orifice if it provides easy access. Common insertion spots including the rectum, mouth, nose, and urinary tract. If there is no good way to reach the site of the suspected tumor through an existing bodily orifice, the doctor will make a small incision to insert the tube through.

Skin Biopsy Procedures

For suspected skin cancer cases, the doctor will usually perform a skin biopsy procedure to remove cells from the surface of the skin. These skin biopsy procedures take one of four forms:

• The first is the shave biopsy. A shave biopsy is just what it sounds like. The physician will use a razor to shave off a small section of skin to be biopsied.
• Next is the punch biopsy. During a punch biopsy procedure, a punch tool is used to extract a tissue sample from one of the deeper layers of skin.
• Third is the incisional biopsy. The doctor uses a scalpel to slice off a small section of skin. This procedure may require stitches to close the wound.
• Finally, there is the excisional biopsy. This skin biopsy procedure also uses a scalpel, but the doctor will remove the entire tumor or portion of abnormal skin. There may be significant bleeding during excisional biopsy procedures, and they usually require stitches.

Surgical Biopsy Procedures

The most serious type of biopsy procedure is the surgical biopsy. This procedure is used when none of the simpler biopsy techniques can reach the site of the suspected tumor. During a surgical biopsy, the oncology surgical specialist will actually cut the patient open and find the site of the suspected tumor. The surgery may be done with a local anesthetic, but it can also require putting the patient to sleep with a general anesthetic.

Waiting for the Results

The hardest part about undergoing biopsy procedures is waiting for the results to come back. This is a nerve-racking time for patients. In rare cases, the results may come back within a matter of minutes. However, most biopsy results take a couple days to come back from the lab.

Once they come back, the doctor will be able to tell the patient if they have cancer. They will be able to identify the type of cancer and what stage it is. With these results in hand, a treatment plan can be formulated to fight cancer and get the patient into recovery.