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Biopsy – Definition, Types and Procedure

A biopsy is the targeted removal of tissue or cells from the body for microscopic examination. It is used to diagnose conditions such as cancer.

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Things worth knowing about "Biopsy"

A biopsy is the targeted removal of tissue or cells from the body for microscopic examination. It is used to diagnose conditions such as cancer.

What is a Biopsy?

A biopsy is a medical procedure in which a small sample of tissue, cells, or fluid is taken from the body and examined under a microscope in a laboratory. The goal is to detect abnormalities in the tissue, establish an accurate diagnosis, and guide the most appropriate treatment. Biopsies are among the most reliable diagnostic tools in modern medicine.

When is a Biopsy Performed?

A biopsy is recommended when imaging techniques such as ultrasound, X-ray, CT, or MRI reveal suspicious findings that require further investigation. Common indications include:

Suspected benign or malignant tumors (e.g., breast cancer, skin cancer, colorectal cancer)
Unexplained tissue changes or lumps
Suspected inflammation or autoimmune conditions
Monitoring organ transplants for signs of rejection
Evaluation of liver or kidney diseases

Types of Biopsy

There are several types of biopsies, each used depending on the location of the tissue and the clinical question being investigated:

Core Needle Biopsy

A hollow needle is used to extract a small cylinder of tissue. This technique is commonly used for examining the breast, prostate, or liver.

Fine Needle Aspiration Biopsy (FNAB)

A thin needle is used to aspirate individual cells or clusters of cells. This minimally invasive method is frequently used for thyroid nodules or lymph nodes.

Incisional Biopsy

A portion of the suspicious tissue is surgically removed for analysis. This approach is used when a larger tissue sample is needed for diagnosis.

Excisional Biopsy

The entire suspicious tissue or tumor is surgically removed and analyzed. This method serves both a diagnostic and therapeutic purpose.

Endoscopic Biopsy

During an endoscopy (e.g., gastroscopy or colonoscopy), tissue is collected from the interior of hollow organs. This procedure is nearly painless and highly precise.

Liquid Biopsy

In a liquid biopsy, tumor cells or tumor DNA are analyzed from a blood sample. This minimally invasive method is gaining importance in cancer diagnostics and monitoring.

How is a Biopsy Performed?

The exact procedure depends on the type of biopsy. In general, the steps are:

Informed consent discussion with the treating physician
Local anesthesia of the affected area (for minor procedures) or general anesthesia (for surgical biopsies)
Tissue sampling under ultrasound, CT, or MRI guidance
Laboratory analysis of the sample by pathologists
Results discussion within a few days to weeks

Risks and Side Effects

Biopsies are generally safe procedures. Possible but rare complications include:

Bleeding at the sampling site
Infection
Pain or swelling
In rare cases, injury to nearby structures

The risk is minimized through image-guided procedures such as ultrasound.

Results and Significance

The result of a biopsy provides essential information about the nature of the removed tissue. The pathology report can reveal whether the tissue is benign or malignant, which cell type is affected, and whether specific treatment is necessary. Based on this report, further therapy is planned.

References

World Health Organization (WHO): Cancer Diagnosis and Pathology. Available at: https://www.who.int/cancer
National Cancer Institute (NCI): Biopsy and Cytologic/Histologic Tests. Available at: https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/biopsy-fact-sheet
Kumar V, Abbas AK, Aster JC: Robbins & Cotran Pathologic Basis of Disease. 10th Edition. Elsevier, 2020.

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