What is a biopsy?
A biopsy is the removal of a small amount of tissue, cells, or fluid to test for medical conditions. Biopsies can be done on any part of your body, including your skin, lymph nodes, bone marrow, or other organs. While some biopsies involve drawing and testing your blood or another bodily fluid, many are performed by removing tissue with a needle or during surgery. These tests can diagnose and monitor conditions, like infections, inflammatory diseases, autoimmune disorders, or cancer.
Penn Medicine’s expert surgeons and radiologists perform a high volume of biopsies, giving us a strong background in this important part of your care. With expertise across all specialties, our providers use advanced technology to precisely target the tissue that needs testing. Then, skilled pathologists examine the samples under a microscope. If a diagnosis is made based on your biopsy, our providers take the time to answer your questions, ensure that you understand the results, and recommend an effective care plan.
Types of biopsies
There are several techniques your doctor might use to take tissue or fluid samples. They range from examining your blood to extracting tissue during a procedure.
A liquid biopsy tests your blood or urine for signs of a tumor. This type of biopsy can detect cancer cells or a tumor’s DNA or RNA to help with a diagnosis or treatment planning.
Shave and punch biopsies are tests of your skin cells to check for skin conditions, like actinic keratosis or skin cancer. A shave biopsy involves using a razor blade to gently remove some of the top layer of your skin. A device can also take a small section about the size of a pencil eraser that includes deeper layers of your skin, known as a punch biopsy.
A needle biopsy involves passing a needle through the area being tested. Fine needle aspiration uses a thin needle and syringe to take tissue, cells, and fluid. A core needle biopsy uses a wider needle to collect more tissue. Sometimes doctors use a suction device to help collect enough tissue. Needle biopsies can help diagnose many medical conditions, including infections, liver disease, breast cancer, and others.
A thin, soft tube called an endoscope may be inserted through your mouth, urinary tract, or rectum to remove tissue. This type of biopsy can diagnose celiac disease, lung cancer, Crohn’s disease, and many other conditions.
When the area being biopsied is deep in your body, like your belly or pelvis, your doctor may perform a laparoscopic biopsy. Small cuts are made to allow a tube with a camera called a laparoscope to be inserted and guided to the area. Surgical instruments are passed through the tube to remove tissue. It can diagnose endometriosis, cervical cancer, chronic kidney disease, or other diseases.
Surgical biopsies require making a cut (incision) to access the tissue that needs to be removed. If your doctor is testing a tumor, bump (nodule), or lymph node, the entire structure may be removed, called an excisional biopsy. If only part of a lump, nodule, or node is removed, it’s known as an incisional biopsy. Surgical biopsies can examine tissue from many parts of your body, including your breast, muscles, lymph nodes, and other areas.
Understanding what to expect from a biopsy and the specific requirements of the procedure depends on the area of the body being tested. Penn Medicine performs every type of biopsy for thorough and precise diagnosis of diseases, infections, and illnesses.
Some of the biopsy types we perform:
Why your doctor might order a biopsy
You may need a biopsy if you have signs of a disease. This may include swelling or a lump you can feel. Your doctor might also have noticed a lump, nodule, or mass on an imaging test. Evaluating your tissue or bodily fluid can determine if you have an infection, blood disorder, or another disease. It can also determine if you have a tumor and whether it’s noncancerous (benign) or cancerous. If you’ve already been diagnosed with cancer, a biopsy can check if the cancer has spread. Biopsies may also be done if you’ve had an organ transplant to check how well your body is tolerating the new organ.
How is a biopsy performed?
The steps of your procedure depend on what type of biopsy you’re having and what area of your body is being tested. Your health care team will let you know what to do to prepare for your appointment. A liquid biopsy may be as simple as providing a blood or urine sample. If you’re having a skin biopsy, it can be done in your doctor’s office by numbing your skin and using a razor, scalpel, or punch device to remove a skin sample.
Other types of biopsies require an outpatient procedure. You may be given a sedation medication to help you relax and an anesthetic to numb the area, or you might have general anesthesia to put you in a sleep-like state. Imaging tests may help guide your doctor to the tissue being collected. During an endoscopic biopsy, surgical instruments are passed through the endoscope to take tissue samples. Needle, surgical, and laparoscopic biopsies involve going through the skin. Afterward, needle biopsies are covered with a bandage, while biopsies that require incisions are closed with stitches or surgical adhesive.
Recovering from a biopsy
You’ll go home the same day after a biopsy. If you had a surgical biopsy, you might stay in the hospital for a few hours after the procedure. Your health care team will let you know when you can return to your typical activities. They’ll also let you know how to care for the wound if you have one. After a laparoscopic biopsy, you may have drainage tubes at the surgical site. Your provider will tell you how to care for the tubes until they’re removed. Before going home, your care team will also let you know when the results of the test are expected to be available.
Biopsy risks
You may have bruising, swelling, scarring, soreness, or some bleeding after a biopsy. There’s a low risk of infection. Contact your health care team if symptoms like pain or swelling get worse or if you have any other concerns after your procedure.
Biopsy FAQs
While biopsies are routine procedures, it’s normal to have concerns and questions before your appointment. We’ve provided answers to some of the most frequently asked questions we receive. Check with your care team if you would like more information.
Almost any part of your body can be biopsied. Common areas include the breast, lymph node, thyroid, liver, kidney, skin, muscle, bone, and bone marrow.
No, needing a biopsy doesn’t mean you’ll be diagnosed with cancer. It’s a tool to help diagnose both noncancerous and cancerous medical conditions. Sometimes doctors recommend a biopsy to check for cancer, but the result may be benign. Don’t hesitate to ask your health care team why you’re getting a biopsy and what it may reveal.
Your provider gives you medications so that you don’t have pain during the procedure. You’ll feel a pin prick when you’re given the anesthetic, and you may feel a sense of pressure during the procedure. If you were given general anesthesia, you’ll be in a sleep-like state and won’t feel anything. Afterward, you may have mild soreness for a few days.
A skin biopsy may take a few minutes, while fine needle aspiration usually lasts about 10 to 15 minutes. A core needle, endoscopic, laparoscopic, and surgical biopsy can take up to an hour or longer.
Your doctor sends the sample to a laboratory to be studied and tested by a pathologist. After examining your samples, the pathologist sends a report to your doctor, who will go over the results with you. The report includes a diagnosis and information about the tissue sample that can help with planning your treatment.
The timeline for receiving your results depends on the type of biopsy you had. Some results are available within a few hours, while others may take days or weeks. Your health care team will let you know when you can expect to receive the results, and your doctor will review them with you.
Skilled diagnostic providers and compassionate care
At Penn Medicine, our top surgeons, radiologists, and pathologists work with your specialist to provide an accurate diagnosis, which helps to shape your treatment plan. Our labs are accredited by the College of American Pathologists (CAP) for accuracy, patient care, and safety. We also support you through every step of the procedure, including preparing for the biopsy, the procedure itself, your recovery, and your care plan going forward.