A biopsy (taking a tissue sample) is one of the most commonly used medical examinations. Tissue samples can be analyzed in order to find out, for instance, whether a suspicious lump is harmless or dangerous. The doctor removes a small sample of tissue and sends it to a laboratory to be examined under a microscope. The tissue sample can often be removed in an outpatient setting (without an overnight stay).
When are biopsies necessary?
If a doctor feels something unusual during a physical examination (palpation), analyzing a sample of tissue can help to find out what it is. Biopsies might also be done to find out more if imaging techniques such as ultrasounds or x-rays show abnormal areas of tissue. Then chronically inflamed tissue can be diagnosed or cancer ruled out, for example. Samples of tissue can be taken from easily accessible parts of the body as well as from many internal organs.
Biopsies are relatively simple procedures that can often be done without having to stay overnight in hospital. The length of the procedure will depend on the part of the body or organ in question and which technique is used.
The doctor will first decide which exact area the tissue should be taken from. For internal organs, this is done with the help of imaging techniques such as ultrasound, (MRI) or (CT) scans. In endoscopy, the tissue sample can be taken during the examination – for example, from the stomach, colon or lungs.
If a tissue sample is removed through a cut in the skin, the skin is disinfected first. Usually just a local anesthetic is needed for a biopsy, depending on the size of the instrument to be used. After an outpatient biopsy has been completed, the wound is covered with a wound dressing. Antibiotics are sometimes prescribed to prevent , for instance after a prostate biopsy.
If the procedure involves an internal organ, such as the liver or kidney, or if the person has poor general health, a hospital stay is often needed. Several biopsies may be needed if the disease is at an advanced stage or if the organ is difficult to reach, such as the prostate gland.
Performing a biopsy
What different types of biopsies are there?
There are two main types of biopsies:
Incisional biopsies: Only a part of the abnormal tissue is removed.
Excisional biopsies: The entire abnormal area is cut out.
Excisional biopsies are mostly done when skin cancer is suspected, but they are also done when looking at colon (which may turn into bowel cancer). The amount of tissue taken depends on the organ in question, the size of the abnormal area, and the type of tissue.
If only a small sample is needed, a needle biopsy is typically done. Here the doctor puts a very thin hollow needle into the tissue. Depending on the diameter of the needle, samples of either individual cells (fine needle biopsies) or small pieces of tissue (core needle biopsies) can be taken. In an open biopsy, by contrast, surgery is done to expose and remove the tissue.
What can a biopsy find?
The tissue sample is examined in a laboratory using a microscope. Dyes can be used to see certain cells or enzymes that may be signs of disease. If cancer is discovered, the tissue sample may also be used to find out what type of tumor it is and how much it has spread through the tissue.
What possible complications are there?
A biopsy may cause bleeding or bruising. A wound or damage to nearby tissue are also possible.
Some people worry that the biopsy may accidentally allow cancer cells to spread to healthy tissue and other parts of the body. But experts currently agree that this is unlikely to happen.
IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
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