What happens during a lymph node biopsy?
Common areas for lymph node biopsies include your armpit, neck, groin, or belly. Your doctor will give you instructions before your procedure on how to prepare for the appointment. Depending on the type of biopsy being done, you may be given sedation to help you relax, a local anesthetic to numb the area, or general anesthesia to put you to sleep. Computed tomography (CT) scans, magnetic resonance imaging (MRI), or ultrasounds may be used before or during the biopsy to help guide your doctor to the lymph node.
During a needle biopsy, your provider uses a needle to reach a lymph node near the surface of your skin and remove tissue. Fine-needle aspiration involves using a small, hollow needle to remove fluid, cells, and tissue. A core needle biopsy uses a slightly larger needle when more tissue is needed for testing. Needle biopsies may take up to a half hour to complete. Once the needle is removed, a bandage is placed over the area.
Sometimes the entire lymph node needs to be removed to ensure there’s enough tissue for testing. To do this, your surgeon conducts an excisional biopsy by making an incision to access the lymph node and remove it. Afterward, the incision is closed with stitches or liquid adhesive. A bandage may be placed over it. An excisional biopsy may take up to 45 minutes.
An incisional biopsy involves making an incision and removing a small part of your lymph node. This type of biopsy may be done if your doctor doesn’t need the entire lymph node or if the node is attached to another structure. After making a cut and removing tissue, your doctor closes the incision with stitches or surgical adhesive and covers it with a bandage. This type of biopsy may take 30 to 45 minutes.
A sentinel lymph node biopsy is mainly used to stage breast cancer or melanoma to help with treatment planning. It’s also sometimes used to stage penile cancer and uterine and endometrial cancer. Before the biopsy, you’re injected with a radioactive solution or blue dye close to the primary tumor. This helps identify which lymph nodes cancer cells would go to first, known as sentinel nodes. Your surgeon makes an incision and removes the sentinel nodes for testing. The biopsy may be done during the same surgery to remove a cancerous tumor. Afterward, the incisions are closed with stitches or surgical adhesive. A sentinel node biopsy may take up to an hour.
If the lymph node being tested is deeper in your body, like in your belly, your doctor may perform a laparoscopic biopsy. You’ll be given general anesthesia before this procedure. Your surgeon will make one or more small incisions, and a tube with a tiny camera and light, called a laparoscope, is used to find the lymph node and remove tissue. This procedure can take up to two hours.