A biopsy procedure is used to remove suspicious material for examination. For people who have not had a biopsy before, it can be a bit alarming to hear that one has been requested. Knowing the details of what to expect can make people feel more prepared, allowing them to relax for the procedure so that it will go smoothly. In all cases, biopsy results should be discussed with a doctor to ensure that the patient knows what the results mean and what sort of response should be taken.
Before a biopsy procedure takes place, a doctor must determine that the patient needs one. A physical examination may reveal an area of concern, such as a patch of skin which has changed color, or a lump in the soft tissue. A biopsy may also be requested if a medical imaging study reveals an irregularity, or if a biopsy would assist a doctor in arriving at a diagnosis.
The first step in a biopsy procedure is preparation of the site and the patient. The site is typically swabbed and washed so that it is sterile, and in areas where there is hair, the site may be shaved. Next, a local anesthetic is injected so that the patient will not experience pain. In some cases, the patient may be offered antianxiety medication to relax for the biopsy. For certain biopsies, the patient may be put under a general anesthetic.
In biopsies where the patient is anesthetized, anesthesia is used for the purpose of a surgical biopsy, in which a doctor cuts into the body to remove a sample from the area of interest. This technique is less common with the advent of several types of needle biopsy, ranging from fine needle aspiration to vacuum-assisted biopsy, in which a large needle is inserted into the area of interest and used to remove a sample from a conscious patient. If the area being biopsied is on the skin, a scalpel will be used to scrape off a sample.
The biopsy may be taken with the assistance of medical imaging such as ultrasound. The medical imaging is used to correctly identify the area of interest so that the sample is taken from the right place. In a wire-guided biopsy, the imaging is used while fine wires are placed to mark the area which needs to be biopsied, and a surgeon uses the wires as a guide for a surgical biopsy. Some procedures may require the use of endoscopic probes which are inserted into the body to generate an image, allowing the doctor to clearly see the site which needs to be biopsied.
If the patient is conscious, he or she will need to hold very still during the biopsy procedure, and it may be necessary to assume a particular position. The biopsy should not be painful, because of the local anesthetic, but it can be uncomfortable. Especially in cases where probes are used, discomfort is common for conscious patients, as for example in an endoscopic biopsy of the esophagus.
In the case of a surgical biopsy, the surgeon will close the site and bandage it, providing the patient with aftercare instructions. Needle biopsies and surface biopsies may ooze slightly, so they are usually covered with light bandages, and the patient may be asked to be careful around the site while it heals.
After the sample has been taken in a biopsy procedure, it can be examined in a laboratory by a pathologist, who will write up a report about what was observed. It may take only a few hours to get biopsy results in some cases, while in other instances it can take days, because the sample could require special treatment or it may need to be sent out to a lab in another area.