What Is Biopsy?
A biopsy is the removal of tissues, cells, or fluids from the living body for examination. The doctor will suggest a biopsy when an initial test shows that the area of tissue in the body is abnormal.
Why Is Biopsy Done?
If a patient experiences any signs and symptoms in a particular area, a biopsy can be done to determine whether they have cancer or any other conditions. In contrast, imaging tests like CT (computed tomography) scan and MRI (magnetic resonance imaging) techniques and x-rays can only determine the abnormal mass in an area. Therefore the only way to assess cancer is to conduct a biopsy for a closer examination. A biopsy can even be done in normal tissues to check whether cancer has spread or to find the transplanted organ's rejection. A biopsy also helps in planning a better treatment option.
What Are the Types of Biopsy?
There are several types of biopsy. All these techniques use only sharp objects to remove the small number of cells or tissues for examination. Anesthesia will be given first if the area where the biopsy to be done is skin or any sensitive area.
1. Bone Marrow Biopsy:
The doctor may recommend a bone marrow biopsy if an abnormality is identified in the blood or if the doctor assumes that cancer has started in or migrated to the bone marrow. Bone marrow is the spongy substance present inside some of the larger bones wherever blood cells are produced. Investigating a sample of bone marrow may reveal what is causing the blood problem.
Bone marrow biopsy is usually used to diagnose various blood disorders, both non-cancerous and cancerous, including blood cancers, like leukemia, multiple myeloma, and lymphoma. This biopsy can also detect cancers that began outside and migrated to the bone marrow. During a bone marrow biopsy procedure, the doctor draws a sample of bone marrow from the back of the hipbone utilizing a long needle. Local anesthesia is given before a bone marrow biopsy to reduce pain during the procedure.
2. Needle Biopsy:
The doctor uses a unique needle to remove the cells from a suspicious area in a needle biopsy technique. A needle biopsy is usually used on tumors that the doctor can reach through the skin, such as enlarged lymph nodes or suspicious breast lumps. When the suspicious area cannot be felt through the skin, it is combined with an imaging procedure, such as an X-ray, to collect cells.
Types of needle biopsy include:
Fine-Needle Aspiration: A long, thin needle is introduced into the suspicious area to draw out fluid and cells for examination.
Core Needle Biopsy. A larger needle with a penetrating tip is used to draw a tissue column from a suspicious area during a core needle biopsy.
Vacuum-Assisted Biopsy: A suction device can increase the amount of fluid and cells obtained through the needle during a vacuum-assisted biopsy. This can lessen the number of times the needle must be injected to collect a sufficient sample.
Image-Guided Biopsy. Image-guided biopsy links the imaging procedure like x-ray, ultrasound, computerized tomography (CT), or magnetic resonance imaging (MRI) with a needle biopsy. Image-guided biopsy is done when the doctor cannot feel the suspicious areas through the skin in case of abnormalities on the liver, lung, or prostate. Using real-time pictures, the doctor can make sure that the needle reaches the exact spot.
3. Endoscopic Biopsy:
A flexible thin tube with a light on its end is inserted to see structures inside the body during an endoscopic biopsy. A special tool is passed into the tube to take a small sample of tissue for an investigation. The type of endoscopic biopsy to be done depends on where the suspicious area is located. Tubes used are inserted through the mouth, urinary tract, rectum, or a small incision in your skin. Some examples of endoscopic biopsy procedures include cystoscopy to obtain tissue from the bladder, bronchoscopy to get tissue from the lung, and colonoscopy to collect tissue from the colon.
4. Skin Biopsy:
A skin biopsy extracts cells from the surface of the body. It is used often to diagnose skin conditions like melanoma and other cancers. The type of skin biopsy done depends on the type of cancer assumed and the unusual cells' extent. The types of skin biopsy include:
Punch Biopsy: A circular tool is used to remove a small segment of the skin's deeper layers.
Shave Biopsy: A tool like a razor is used to scrape the surface of your skin in a shave biopsy procedure.
Incisional Biopsy: The doctor will use a scalpel to extract a small area of skin. The amount of skin removed determines whether there is any need for stitches to close the biopsy site in an incisional biopsy procedure.
Excisional Biopsy: An entire lump or a total area of abnormal skin is removed in case of an excisional biopsy. The doctor may apply stitches to close the biopsy site.
5. Surgical Biopsy:
The doctor will make a penetration in the skin to reach the cells' suspicious area. Examples of surgical biopsy procedures involve surgery to eliminate a breast lump for a possible breast cancer analysis and surgery to remove a lymph node for a probable lymphoma diagnosis.
6. Liver Biopsy:
A needle is injected into the liver into the skin on the belly for obtaining the liver tissue.
7. Kidney Biopsy:
A kidney biopsy is similar to a liver biopsy, where a needle is inserted into the skin on the kidney's back.
8. Prostate Biopsy:
A probe is implanted into the rectum to enter the prostate.
How Is a Biopsy Analysed?
Once the biopsy sample is collected, it will be sent to the pathologist in a lab to be examined. These samples can be frozen or chemically treated and sliced into very thin segments. The sliced sections are placed on a glass slide and stained to improve the contrast, which is viewed under the microscope.
What Are the Complications of a Biopsy?
In any medical procedure that requires piercing, the skin may undergo the risk of infection or bleeding. Still, as the incision is small, particularly in a needle biopsy, the risk is minimal.
Biopsy, an invasive investigational and therapeutic procedure, is most commonly suggested by healthcare professionals to differentiate between aggressive tumors, simple cysts and tumors. Apart from imaging tests, biopsy serves as the best diagnosing tool to rule out the type and causes of abnormal growths.
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