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When your doctor checks for cancer, he or she may need to take tissue or cell samples from one or more parts of your body. The tumor’s location and suspected type of cancer determine how the doctor takes these samples.
When your doctor checks for cancer, he or she may need to take tissue or cell samples from one or more parts of your body. The tumor’s location and suspected type of cancer determine how the doctor takes these samples.
Some biopsies involve removal of tumor samples through an endoscope, a lighted tube inserted into your body. Other biopsies remove samples using a thin needle. Still others involve removal of an entire organ by a surgeon. We explain the most common types of biopsies below.
Needle Biopsy for Cancer Detection
The two types of needle biopsies are fine needle aspiration and core needle biopsy.
Fine Needle Aspiration
Fine needle aspiration involves using a thin, hollow needle with an attached syringe. For tumors on or near the body’s surface, the doctor aims the needle by hand. If the tumor cannot be reached this way, an imaging test such as an ultrasound or CT scan guides the doctor to the correct location. The biopsy takes place through removal of a small amount of fluid and tiny pieces of tumor tissue.
Your doctor makes no skin cuts for fine needle aspiration. But sometimes the needle cannot remove enough tissue for clear diagnosis. When the doctor obtains enough tissue, in some cases you know your diagnosis within just one or more days.
Core Biopsy
For a core biopsy, your doctor uses a slightly larger needle than in fine needle aspiration. These extract a small cylinder of tissue from the tumor area. Local anesthesia numbs the area of the procedure for your comfort. Sometimes a special vacuum suctions a larger core biopsy for breast cancer sampling. Lab review of core biopsies take longer than fine needle aspiration, so receiving your test results also takes longer.
Excisional or Incisional Biopsy
For excisional biopsy, a surgeon removes the entire tumor. Incisional biopsy involves removal of a small part of a large tumor. For these procedures, the surgeon cuts through your skin. So local or regional anesthesia numb the area. When your tumor is inside your abdomen or chest, you undergo general anesthesia.
Endoscopic Biopsy
Endoscopic biopsy involves insertion of an endoscope, a thin and flexible tube with a light, lens or video camera on the end. An endoscope enables your doctor to see inside your body without major surgery. Using an endoscope, he or she can also take tissue samples for biopsy.
There are several different kinds of endoscopes. Each works in certain areas of the body. A bronchoscope works inside the lungs and breathing tubes, called bronchi. A colonoscope works for seeing inside your large intestine.
Laparoscopic, Mediastinoscopic and Thoracoscopic Biopsies
Laparoscopic biopsy works like endoscopic biopsy, but with a scope designed for viewing inside the abdomen and taking tissue samples there. For this procedure, a surgeon makes a small incision and passes the laparoscope into the abdomen. A thoracoscopic biopsy or mediastinoscopic biopsy involve the chest area.
Laparotomy and Thoracotomy
For laparotomy, the surgeon cuts into your abdomen. This test works well when needle biopsies or laparoscopes will not provide enough information for diagnosis. Using laparotomy, the doctor sees the area’s size, location and nearby tissues. You undergo general anesthesia for this procedure. When this procedure takes place in the chest, your doctor calls it a thoracotomy.
Skin Biopsy for Skin Cancers
Doctors decide which method of skin biopsy works best for your specific skin issue. For basal cell or squamous cell skin cancers, the test of choice may be a shave biopsy. A shave biopsy removes outer layers of skin for testing. For deeper layers of the skin, punch biopsies or excisional biopsies remove samples sufficient for determining how deeply the melanoma has gone.
Sentinel Lymph Node Mapping and Biopsy
Mapping of lymph nodes enables surgeons to determine which lymph nodes must be removed for biopsy. Doctors commonly use this procedure to find out whether cancer involves lymph nodes. It involves the lymph nodes closest to where the cancer began. To find the right lymph nodes, your doctor injects radioactive material into the cancerous area. A machine then detects which lymph nodes are most vulnerable to that cancer. Your doctor injects blue dye into the cancer site, with a surgeon entering that lymph node area through a cut in the skin. Through this procedure and its results, your surgeon can tell which lymph nodes must be removed as part of lymph node dissection.