A biopsy is sometimes inconclusive, 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.
There are many ways of getting a tissue sample, depending on the type of tissue being collected and where in the body it's being taken from. Imaging techniques, such as X-ray , ultrasound , CT scanning or MRI scanning is often used to guide many types of biopsy. During a punch biopsy, a special surgical instrument is used to make a small hole in the skin and remove samples of the top layers of tissue. If you have a punch biopsy, you'll usually be given local anaesthetic to numb the area.
Alternatively, a scalpel a sharp medical knife may be used to remove a small amount of surface skin. The wound will be closed using stitches. A fine-needle aspiration FNA biopsy is often used to take cell samples from organs or from lumps that are below the surface of the skin. If a larger sample is needed, a core needle biopsy CNB will be used instead.
For core biopsies, after local anaesthetic has been given, a hollow needle is inserted through the skin and into the area being examined. X-ray, ultrasound, CT or MRI scanning will often be used to help guide the needle to exactly the right place. When the needle is in position, it will cut out a small sample of tissue. For core biopsies, local anaesthetic is usually used to numb the area, so that you won't experience any pain or discomfort. In many cases, a needle biopsy can be used to get more information about a breast lump.
The needle is inserted into the lump and a sample of tissue will be taken for testing. A core needle biopsy CNB is often used to obtain a larger tissue sample. In some cases, when a cyst a benign fluid-filled swelling is suspected, a fine needle will be used to drain the fluid and the cells sent for examination cytology. A thicker, hollow needle is used for taking organ biopsies, such as of the liver or kidneys. These are often carried out with imaging guidance ultrasound or CT , and you may be asked to hold your breath for a few seconds while the needle is inserted into your abdomen tummy.
A thick needle is used to take samples of bone marrow the soft, jelly-like tissue found in the hollow centre of large bones. Bone marrow biopsies can be carried out for a number of different reasons, including to find out why you have a low or high number of:. A large number of different health conditions may be responsible for these types of blood abnormalities.
Where a diagnosis has already been made, samples of marrow may be taken to check how well treatment is working — for example, in leukaemia. Samples of bone marrow are also sometimes taken to check how well treatment for leukaemia is working, or to determine how far certain types of cancer have progressed what stage it's at. Bone marrow biopsies are usually taken from the top of the pelvic bone, just below your waist.
You'll usually have a local anaesthetic to numb the area, and you may also be given a sedative to help you relax and cope with any discomfort or anxiety. An endoscope is a medical instrument used to look inside your body.
It's a thin, flexible tube with a light and a camera at one end. Small cutting tools can also be attached to the end of an endoscope to allow the endoscopist surgeon, doctor or nurse specialist to take a tissue sample. An endoscope can be inserted down your throat upper gastrointestinal , or from below through the anus lower gastrointestinal , depending on the area being examined.
The type of anaesthetic used will also depend on the area of the body being investigated and the entry point of the endoscope. An excisional biopsy is used to remove a larger area of tissue, such as a lump, for closer examination. The type of anaesthetic used will depend on where the tissue is. A tissue sample is taken during surgery and can be checked immediately known as a "frozen section" so that the surgeon can get the results while the operation is in progress. This can help them decide how to manage the treatment.
A lump found during surgery may be removed completely if the patient is still under anaesthetic, providing that previous consent has been given. After a tissue sample has been taken, it will be sent to a laboratory to be examined under a microscope. Closely examining the cells in the tissue sample enables histologists doctors who specialise in studying the structure of tissues to determine whether they're normal or abnormal. Excisional biopsy — the lump is entirely removed.
Depending on the location of the lump, the patient may need to undergo general anaesthesia. This type of biopsy may be used for breast lumps. Incisional biopsy — only a small slice of the lump is removed. Depending on the location of the lump, a general or local anaesthetic may be needed.
This type of biopsy may be used for lumps located in connective tissue such as muscle. Needle biopsy — a small sample of the lump is removed via a slender hypodermic needle. This can be done either with or without local anaesthetic. This type of biopsy may be used to diagnose conditions of the liver or thyroid.
Punch biopsy — a special tool is used to punch a hole through the uppermost layers of the skin. The anaesthetic used may be local or topical. This type of biopsy can help diagnose various skin conditions. This type of biopsy is usually performed whenever the lump is hard to see or feel. Immediately after the biopsy How you feel after the biopsy depends on what sort of procedure was performed.
Generally, you can expect after a biopsy: Some pain around the biopsy site. This should resolve, or at least ease over the next two or three days. Your doctor will prescribe appropriate pain relieving medication. Nurses monitor your condition for some hours and check for bleeding from the biopsy site.
You may have a blood count test to double-check that you are not bleeding internally from the biopsy site. You may undergo other tests to make sure all is well: for example, a chest x-ray if you had a lung biopsy. Surgical medications can sometimes make you drowsy, so you should not drive yourself home. Ask a friend or relative to pick you up or take a taxi. Complications from a biopsy Depending on the biopsy procedure, possible complications include: Excessive bleeding haemorrhage Infection Puncture damage to nearby tissue or organs Skin numbness around the biopsy site.
Taking care of yourself at home Be guided by your doctor or surgeon, but general suggestions include: Rest as much as you can in the next day or two. Limit using the body part, if this is possible. For example, if you had a biopsy performed on your arm or leg, try to rest and raise the limb for the next day or so. Avoid vigorous exercise and lifting heavy objects. You may need to keep your wound and its dressing dry for around one week to 10 days.
If possible, hold the affected area out of the shower or bath, or cover the dressing in plastic wrap. It can also be useful in helping to determine a person's overall prognosis outlook.
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. There are various types of biopsy that can be used to help identify a wide range of health conditions.
How a biopsy is carried out will depend on where the tissue sample is being taken from. After the tissue sample is taken, it will be examined under a microscope to help identify the nature of the problem. This often means that a definite diagnosis can be made. The type of stains and tests that are used when the tissue is examined under the microscope will depend on the medical condition being investigated.
Most biopsies will only require local anaesthetic , which means you won't need to stay in hospital overnight. But an overnight stay is usually required when the procedure is carried out under general anaesthetic.
Most types of biopsy are painless once the anaesthetic starts to work, although this depends on where the sample is taken. You may experience a dull ache, which can be treated with painkillers on the advice of your doctor or surgeon.
Read more about recovering from a biopsy.
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