Being told you need a biopsy can be frightening, because many people link the word with cancer. In reality, many biopsies show harmless conditions, and a biopsy is often the quickest way to get a clear answer.
Imagine waiting for a phone call about the lump in your neck. Every time your phone rings, your heart jumps. Understanding the process, and knowing how to get through the wait, can make those days a little easier.
What a biopsy is
A biopsy is a procedure to remove a small sample of tissue or cells so it can be examined under a microscope by a pathologist. It is used to find out what is causing a lump, an abnormal scan finding, a skin change or abnormal blood results.,A biopsy can show whether cells are normal, inflamed, infected, pre-cancerous or cancerous. If cancer is found, it gives important information about the type and how fast it is likely to grow, which guides treatment.
Common types of biopsy
- Needle biopsy: a thin or core needle takes cells or tissue, often guided by ultrasound or CT; used for breast, thyroid, liver, lymph node and other lumps
- Skin biopsy: a small piece of skin is removed with a punch, shave or scalpel
- Endoscopic biopsy: samples are taken during a gastroscopy, colonoscopy or bronchoscopy
- Bone marrow biopsy: a sample from the hip bone, used for blood disorders
- Excision biopsy: the whole lump or area is removed
- Surgical biopsy: taken during an operation when other methods are not possible
How to prepare
- Ask exactly what type of biopsy you are having and how long it will take
- Tell the team if you take blood thinners, aspirin or supplements such as fish oil, as these may need to be paused
- Check whether you need to fast, which is common if sedation is used
- Arrange someone to take you home if you are having sedation
- Tell the team about allergies, especially to local anaesthetic, latex or plasters
What it feels like
Most biopsies are done under local anaesthetic, which stings briefly as it is injected and then numbs the area. You may feel pressure, pushing or a clicking sound with some core biopsy needles, but should not feel sharp pain. Tell the team if you do; they can give more anaesthetic.,Afterwards, the area may feel sore and bruised for a few days. Simple painkillers usually help.
Risks
Biopsies are generally safe. Possible risks depend on the type and site, and include bleeding, bruising, infection, and pain. Some internal biopsies, such as lung or liver biopsies, have specific risks that the team will explain. Seek help if you have increasing pain, swelling, redness, fever or bleeding that will not stop.
How long results take
Results often take one to two weeks, sometimes longer if special tests are needed on the sample. Some cancer pathways aim for faster results.,Ask before you leave how and when you will get your results, who will contact you, and who to call if you have not heard by a certain date. Many people find it helpful to bring someone with them to the results appointment.
Coping with the wait
- Plan activities and distractions for the days ahead
- Limit late-night searching online, which often increases anxiety
- Talk to someone you trust about how you feel
- Write down questions as they come to you
- Keep up with sleep, food and gentle exercise
- Contact a support line or charity if anxiety becomes overwhelming
Understanding your report
Pathology reports use technical terms such as benign (not cancer), malignant (cancer), dysplasia (abnormal cells that could become cancer) or atypical (cells that look unusual). Ask your healthcare provider to explain what your result means for you and what happens next. You can ask for a copy of the report.
Questions to ask at your results appointment
- What did the biopsy show?
- Do I need any more tests?
- What are my treatment options, if any?
- Is there anything I should do or avoid now?
- Who can I contact if I have more questions?
Image-guided biopsies
Many biopsies of internal organs are guided by ultrasound, CT or MRI so the radiologist can see exactly where the needle is going. Ultrasound-guided biopsies are common for breast, thyroid, liver and lymph node lumps. CT-guided biopsies are used for deeper areas such as the lungs or bones.
For some biopsies, you will need to lie still in a certain position and may be asked to hold your breath for a few seconds while the sample is taken.
Liquid biopsy
A liquid biopsy is a blood test that looks for fragments of tumour DNA in the blood. It is increasingly used in some cancers to guide treatment or monitor response, but it does not yet replace a tissue biopsy for most diagnoses.
Caring for the biopsy site
- Keep the dressing clean and dry for the time advised
- Avoid heavy lifting or strenuous exercise for a day or two after some biopsies
- Watch for redness, swelling, warmth or discharge, which may suggest infection
- Take simple painkillers if needed, avoiding anti-inflammatories if you have been told to
Frequently asked questions
Can a biopsy spread cancer?
This is a common worry. For most biopsies the risk is extremely low, and teams use techniques to minimise it.
Will I have a scar?
Needle biopsies usually leave a tiny mark. Skin and excision biopsies may leave a small scar.
Can I go back to work the same day?
Often yes after a simple needle or skin biopsy, but not after sedation.
But what if the result is bad news?
If the biopsy shows something serious, you will be supported by a specialist team, often including a specialist nurse. Getting a clear diagnosis is the first step to the right treatment.
Your next step: Before your biopsy, ask when and how you will get your results, and write the answer down.
Related: Mammogram and breast screening
Sources: NHS, Cancer Research UK, Macmillan Cancer Support, American Cancer Society, US National Cancer Institute.
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