Biopsy

A biopsy takes a small sample of cells or tissue so that it can be tested in a laboratory. A pathologist, a doctor trained to recognise disease by studying cells under a microscope, examines it. A biopsy can be taken from almost any part of the body, using a needle, an endoscope (a thin tube with a camera), or a small operation that removes part or all of an abnormal area.

A thin needle, used in fine needle aspiration (FNA or FNAC), removes tissue or fluid. A wider core needle removes small pieces of tissue called cores.

A doctor may ask for a biopsy to find the cause of a lump or other symptoms, to follow up an unclear blood test or scan, or to keep track of a long-term condition. Biopsies are done for many reasons, not only cancer, and many lumps and abnormal findings turn out not to be cancer. In most cases a biopsy is the only test that can tell for sure whether a suspicious area is cancer.

The team will tell you whether you need to prepare. You can ask them any questions.

The details depend on the type, but a biopsy usually goes like this:

1. A local anaesthetic usually numbs the area. You may also be given sedation to help you relax, or a general anaesthetic so that you are asleep.
2. The sample is taken with a needle, an endoscope, or by cutting out part or all of the abnormal area. A scan such as ultrasound may guide the needle.
3. The sample goes to a laboratory.

Needle biopsies are usually done as outpatient procedures. If a sample is taken during an operation, a quick answer is sometimes given in about 15 to 20 minutes, with a fuller report later.

You can usually go home the same day. If you have stitches or a dressing, the team will explain how to look after the wound and which painkiller to use, such as paracetamol. Pain or discomfort is common. Contact your healthcare team if pain is not eased by painkillers or is getting worse, you have a high temperature, blood or fluid leaks from the site, or the area is swollen or red.

A biopsy is common and usually very safe. Pain at the site is common, and infection is possible. A biopsy of the womb or cervix may cause cramping or light vaginal bleeding. Some types carry a risk of bleeding inside the body, and the team will tell you the warning signs.

The pathologist usually sends the report to your doctor within about 10 days, though it can take a few weeks or longer. If you have heard nothing after a few weeks, contact your healthcare team. A doctor will explain the report and what comes next.

The report says what the cells look like and gives the diagnosis. The words benign (not cancer) and malignant (cancer) may appear. Many results show a condition that is not cancer. If cancer is found, the report adds details that help plan treatment.

What a biopsy cannot show: a small sample may not tell the whole story, so a second biopsy or other tests are sometimes needed. Scans can show where a problem is, but often only a biopsy can say what it is.