What is Biopsy

A Biopsy is the removal of tissue from any part of the body, to examine for disease. Some biopsies may be required to extract a small sample of tissue with a needle while others may be needed to extract a suspicious nodule or lump. The test can be used to evaluate samples of tissue from any part of the body to allow microscopic examination of the sample. Since most biopsies are minor procedures, patients usually do not need sedation. However, sometimes local anaesthesia may be used.

How is Biopsy used in cancer?

Biopsies are performed in various areas of the body and for several reasons. Different types of biopsies and the conditions when they may be performed are mentioned below:

• Abdominal biopsy: To examine whether a lump in the abdomen is cancerous or benign.
• Bone biopsy: To diagnose bone cancer.
• Bone marrow biopsy: To diagnose cancer in the blood, such as leukaemia.
• Breast biopsy: To examine if a lump in the breast is cancerous or benign.
• Endometrial biopsy: To examine the lining of the uterus and to diagnose cancer.
• Kidney biopsy: To evaluate the condition of a failing kidney or a suspected tumour.
• Liver biopsy: To diagnose diseases of the liver such as hepatitis, cirrhosis, and cancer.
• Lung or chest nodule biopsy: When an anomaly of the lung is noticed on an x-ray/CT scan.
• Lymph node biopsy: To examine an enlarged lymph node for cancer diagnosis.
• Muscle biopsy: To diagnose infections, defects and diseases of the connective tissue.
• Nerve biopsy: To examine damage, degeneration and destruction of the nerve cells.
• Skin biopsy: To examine a growth or an area on the skin that has changed its appearance.
• Testicular biopsy: To determine if a lump in the testicles is cancerous or benign.
• Thyroid biopsy: To find the cause of a nodule in the thyroid gland.
• Liquid Biopsy: To confirm the presence of cancer cells in the blood or other body fluids.

How does the procedure work?

The type of procedure used to conduct the Biopsy depends on the location of the tissue that needs to be studied. Biopsy can be performed using a needle tool, in most of the body parts. It is the least invasive option, allowing the patient to return home on the same day. Imaging guidance with x-ray, ultrasound, CT or MRI helps the needle to be precisely positioned to find the best site to extract the tissue sample.

In places that are hard to reach, a surgical Biopsy may be necessary. This is performed in a hospital operating room. A surgeon performs Surgery to remove the tissue, necessary for the Biopsy. The surgeon may use a camera-based instrument to help locate the best place for Biopsy and remove the sample of tissue. The surgeon inserts the needle through the skin using imaging guidance. Tissue samples may be removed using one of several methods.

• Fine needle aspiration uses a very thin needle attached to a syringe to extract a small amount of body fluid or very small pieces of tissue from the tumour.
• In core biopsy, slightly larger needles are used. They extract tissue in the shape of a small cylinder. Local anaesthesia is used during a core needle Biopsy.
• In a vacuum-assisted biopsy, the needle is positioned into the tumour. The vacuum device is activated to pull the tissue into the needle, and then the tissue is cut using a sheath. The tissue is then sucked through the needle.