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Biopsy: Types of biopsy procedures used to diagnose cancer
A skin (cutaneous) biopsy removes cells from the surface of your body. A skin biopsy is used most often to diagnose skin conditions, including cancers, such as melanoma. What type of skin biopsy you undergo will depend on the type of cancer suspected and the extent of the suspicious cells. Skin biopsy procedures include:
- Shave biopsy. During a shave biopsy, the doctor uses a tool similar to a razor to scrape the surface of your skin.
- Punch biopsy. During a punch biopsy, the doctor uses a circular tool to remove a small section of your skin's deeper layers.
- Incisional biopsy. During an incisional biopsy, the doctor uses a scalpel to remove a small area of skin. Whether you receive stitches to close the biopsy site depends on the amount of skin removed.
- Excisional biopsy. During an excisional biopsy, the doctor removes an entire lump or an entire area of abnormal skin. You'll likely receive stitches to close the biopsy site.
You receive a local anesthetic to numb the biopsy site before the procedure.
If the cells in question can't be accessed with other biopsy procedures or if other biopsy results have been inconclusive, your doctor may recommend a surgical biopsy. During a surgical biopsy, a surgeon makes an incision in your skin to access the suspicious area of cells. Examples of surgical biopsy procedures include surgery to remove a breast lump for a possible breast cancer diagnosis and surgery to remove a lymph node for a possible lymphoma diagnosis.
Surgical biopsy procedures can be used to remove part of an abnormal area of cells (incisional biopsy). Or surgical biopsy may be used to remove an entire area of abnormal cells (excisional biopsy).
You may receive local anesthetics to numb the area of the biopsy. Some surgical biopsy procedures require general anesthetics to make you unconscious during the procedure. You may also be required to stay in the hospital for observation after the procedure.
Biopsy analysis and results
After your doctor obtains a tissue sample, it's sent to a laboratory for analysis. The sample may be chemically treated or frozen and sliced into very thin sections. The sections are placed on glass slides, stained to enhance contrast, and studied under a microscope.
The results help your doctor determine whether the cells are cancerous. If the cells are cancerous, the biopsy results can tell your doctor where the cancer originated — the type of cancer.
A biopsy also helps your doctor determine how aggressive your cancer is — the cancer's grade. The grade is sometimes expressed as a number on a scale of 1 to 4, and is determined by how cancer cells look under the microscope. Grade 1, or low-grade, cancers are generally the least aggressive and grade 4, or high-grade, cancers, generally the most aggressive. This information may help guide treatment options. Other special tests on the cancer cells also can help to guide treatment choices.
In certain cases, such as during surgery, a pathologist examines the sample of cells immediately and results are available to your surgeon within minutes. But in most cases, the results of your biopsy are available in one or two days. Some samples may need more time to be analyzed. Ask your doctor how long to expect to wait for your biopsy results.Previous page
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- Biopsy — What to expect. Cancer.Net. http://www.cancer.net/patient/All+About+Cancer/Cancer.Net+Feature+Articles/Cancer+Screening+and+Prevention/Biopsy%26mdash%3BWhat+to+Expect. Accessed Jan. 14, 2011.
- How are basal and squamous cell skin cancers diagnosed? American Cancer Society. http://www.cancer.org/Cancer/SkinCancer-BasalandSquamousCell/DetailedGuide/skin-cancer-basal-and-squamous-cell-diagnosis. Accessed Jan. 14, 2011.
- Pathology reports. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Detection/pathology-reports. Accessed Jan. 14, 2011.
- Tumor grade: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Detection/tumor-grade. Accessed Jan. 14, 2011.