Types of Biopsy

What are the Types of Biopsy?

• Image-guided biopsy: If the tumor is located deep inside your body and your doctor cannot physically examine the tumor in areas like the liver, lung or prostate, he may use an imaging technique to guide a needle to the location of the tumor. This imaging technique may use ultrasound, X-ray, CT scan, MRI scan (magnetic resonance imaging) or fluoroscopy to guide the needle to the site of cancer. 
• Fine needle biopsy: During the fine needle biopsy, a long thin needle is inserted into the suspected area. A syringe is used to draw out fluid and cells for analysis and this is a minimally invasive procedure. This type of biopsy is often used on tumors that your doctor can feel through your skin, such as enlarged lymph nodes.
• Core needle biopsy: During the core needle biopsy, a larger needle with a cutting tip is inserted into the suspected area removing a larger sample of tissue. The core needle biopsy is also minimally invasive.
• Vacuum-assisted biopsy: Your doctor may use a suction device to collect a tissue sample using a special needle. During a vacuum-assisted biopsy, a suction device is used to collect a tissue sample using a special needle. This test is usually done in the outpatient department of a hospital and is common in breast cancer diagnoses. It is not usually painful and is performed under local anesthesia.
• Excisional biopsy: During an excisional biopsy, the doctor removes an entire lump or an entire area of abnormal skin for tests. You will also receive stitches to close the biopsy site.
• Shave biopsy: Your doctor may remove a small tissue sample from the surface of the skin.
• Punch biopsy: Sometimes, your doctor may prefer to ‘punch’ a sample of tissue from below the skin surface using a circular tool.
• Laparoscopic biopsy: To see abnormal tissues in the abdomen, your doctor may insert a thin tube with a video camera at its mouth through a small incision. He may then remove a small sample using a fine needle.
• Endoscopic biopsy: Similar to a laparoscopic biopsy, your doctor may use a thin endoscope tube through your mouth or through a tiny incision. This type of biopsy is used for areas in the bladder, joints, GI tract, and abdomen. A small sample of tissue may be removed using forceps that are a part of the endoscope. Depending on the type of endoscopic biopsy, you will receive a sedative or anesthetic before the procedure.
• Bone Marrow Biopsy and aspiration: During a bone marrow biopsy, your doctor draws a sample of the bone marrow from your hip bone using a long needle. In order to take solid and liquid samples of suspected bone marrow, your doctor may use two needles for biopsy and aspiration. These two procedures are often performed at the same time. Bone marrow biopsy is used to diagnose both non-cancerous and cancerous blood disease which also includes leukemia, lymphoma and multiple myeloma. You will receive local anesthesia before a bone marrow biopsy in order to minimize discomfort during this procedure.
• Liquid biopsy: Liquid biopsy is used to test for blood cancer. A routine blood test will be analyzed in a special way for diagnosis or to check the progress of a tumor or the success of treatment. Liquid biopsy is relatively new and not widely used for cancers yet.

What are the Common Biopsy sites?

• Bone marrow 
• Brain 
• Breast 
• Gastrointestinal tract (stomach and intestines) 
• Liver 
• Lung 
• Lymph nodes 
• Skin 
• Thyroid 

After a biopsy test, the tissue specimen is sent to the pathology lab to be examined and analyzed.

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