
A biopsy is a medical procedure that involves the extraction of sample cells or tissues from the body to examine more closely under a microscope. This process is important for diagnosing diseases, especially cancer, by allowing pathologists to observe the cellular structure and detect the presence of disease conditions within the sample.
Types of biopsies
Biopsies can be performed using various methods, depending on the location and nature of the suspected disease. Some common types include:
- Fine needle aspiration biopsy (FNAB): A fine needle is used to extract tissue or fluid samples from muscles, bones, or organs.
- Excisional biopsy: Involves the removal of an entire lump or targeted area for examination and testing.
- Incisional biopsy: Only a small section of the abnormal tissue is cut out for examination.
- Endoscopic biopsy: Performed with an endoscope, a thin, flexible tube equipped with a light and camera, to collect tissue from the inside of the body, such as the stomach or colon.
- Skin biopsy: Involves taking a small sample of skin.
The chosen biopsy technique depends on several factors, including the size, location, and type of suspected abnormality. After the biopsy, the collected samples are prepared on slides and examined by pathologists who provide a diagnosis that guides treatment decisions.
Reasons for performing a biopsy
Biopsies are performed for several reasons, primarily in the diagnosis and management of diseases. Common reasons for performing a biopsy include:
- Diagnosis: The primary reason for performing a biopsy is to diagnose a disease or condition, especially when imaging tests like X-rays or MRIs show an area of abnormal tissue. Biopsies can confirm or rule out the presence of cancer, inflammatory conditions, infections, and other pathologies.
- Type and grade of disease: In cases of cancer, a biopsy can determine the type of cancer, its grade (aggressiveness), and other characteristics essential for selecting the most effective treatment plan.
- Stage of cancer: Biopsies can help in staging cancer, indicating how advanced the disease is, whether it has spread, and if so, how far. This information is crucial for prognosis and choosing the appropriate treatment strategy.
- Treatment planning: The detailed information obtained from a biopsy about the cellular makeup of a tumor or lesion helps doctors tailor treatment to the specific type of disease. For example, certain targeted therapies are only effective against cancers with specific genetic markers that can be identified through biopsy analysis.
- Monitoring treatment response: Biopsies can also be used during or after treatment to assess how well the disease is responding to therapy. For instance, a decrease in cancer cells or changes in the characteristics of the cells can indicate the effectiveness of the treatment.
- Inflammatory diseases: Beyond cancer, biopsies are used to diagnose a variety of inflammatory diseases by analyzing the pattern of inflammation in tissue samples, which can help in distinguishing between different types of inflammatory conditions and selecting appropriate treatments.
- Infections: Biopsies can identify infections, especially those caused by fungi, parasites, or unusual bacteria, by allowing for the direct observation of the infectious agent in tissue samples.
What are the limitations of a biopsy?
Biopsies are typically not used to completely remove abnormal tissue or cure a disease. For instance, when a biopsy is conducted on a breast lump, it usually doesn’t entail removing the entire lump. The main goal of a biopsy is diagnostic—to ascertain what the lump is. If it’s necessary to eliminate the lump entirely, a more comprehensive surgical operation, such as excision or resection, would be undertaken.
A biopsy samples only a small section of tissue, which means there’s a possibility that the unsampled tissue might contain crucial information that could affect the diagnosis. Therefore, pathologists base their diagnosis solely on the characteristics of the biopsy sample they examine.
This approach can sometimes lead to a preliminary or partial diagnosis. For example, a biopsy from a large tumor might confirm the presence of cancer, but not specify the cancer type. A more detailed diagnosis is provided once the tumor is fully removed and examined, allowing for a thorough analysis of all the tissue.
About this article
Doctors wrote this article to help you read and understand your pathology report. Contact us with any questions about this article or your pathology report. Read this article for a more general introduction to the parts of a typical pathology report.
Other helpful resources
Atlas of Pathology