Biopsy Types and Information

A biopsy is a procedure in which a small amount of tissue is removed from the body for further analysis. A biopsy may be its own procedure or be included as part of a larger surgery. The tissue that is taken during a biopsy is prepared in various ways and examined by a physician, usually a pathologist. A pathologist is a medical doctor who has completed specialized training in the diagnosis and classification of disease based on anatomical information, usually from a biopsy sample.

There is a number of different biopsy types that differ based on their degree of invasiveness. The least invasive biopsy is a skin biopsy. The area is numbed with local anesthetic and the physician, usually a dermatologist, cuts out the abnormal area and sends it to a pathologist. This type of biopsy is diagnostic but can be therapeutic as well-in most cases the skin lesion is removed along with a portion of healthy skin around it.

The next most invasive biopsy procedure is a needle aspiration or needle biopsy. Most needle biopsy procedures could also be referred to as percutaneous biopsy since tissue is obtained "across the skin." A needle biopsy is a good approach when the abnormality can be reached by a needle since it may circumvent the need for surgery altogether. Common lesions that are sampled by needle biopsy are breast lumps and lesions that can be felt under the skin.

To improve the likelihood that a needle biopsy hits the mark, the biopsy procedure may be combined with various imaging techniques like X-rays and CT scans. A special CT scanner called a fluoroscope can give physicians a real time picture of the area that is being biopsied.

The next most invasive form of biopsy is an endoscopic biopsy. An endoscope is a long, thin device that has a video camera and tiny surgical instruments in the tip that can be controlled by a physician at the other end of the device. An endoscope can be used to obtain a biopsy from various locations in the body. The most commonly performed biopsy procedures are biopsies taken during colonoscopy sampling large intestine), during EGD (sampling esophagus, stomach, and/or first part of the small intestine) and during bronchoscopy (sampling lung tissue).

A biopsy can be performed laparoscopically. In this biopsy procedure small incisions are made in the skin and a device like an endoscope is placed in the incision. This biopsy surgery is used for abnormal growths that are on or near the surface of internal organs. For example, a cyst of the ovary or kidney may be subjected to this form of biopsy.

The most invasive biopsy is one that is performed as part of an open surgery. A relatively large incision is made in the skin and the area to be removed is directly seen by the surgeon. A common biopsy surgery performed in this way would be the biopsy of a liver tumor or lung tumor (that cannot be reached during a bronchoscopy). An open biopsy surgery may be performed as a routine part of most surgeries. While it may not technically be referred to as a biopsy in these cases, a sample of human tissue is sent to a pathologist for analysis nonetheless.