Introduction of biopsy

A biopsy is a medical procedure that involves taking a small sample of tissue so that it can be examined under a microscope.

A tissue sample can be taken from almost anywhere on, or in, your body, including the skin, stomach, kidneys, liver and lungs.

The term biopsy is often used to refer to both the act of taking the sample and the tissue sample itself.

What is a biopsy used for?

Biopsies can be used to investigate the cause of a person’s symptoms or to help diagnose a number of different health conditions. They are also often used to identify abnormal cells and to help identify a specific type of condition.

Where a condition has already been diagnosed, a biopsy can be used to measure how severe it is or what stage it is at. For example, the results of a biopsy can show how severely an organ, such as the liver, is inflamed.

Biopsies can often help diagnose or rule out:

• cancer 
• peptic ulcers – ulcers affecting the digestive system
• hepatitis – inflammation of the liver
• kidney disease
• endometriosis – where cells that usually line the womb are found elsewhere in the body

It is impossible to tell whether a lump or growth on your skin or inside your body is cancerous (malignant) or non-cancerous (benign) just by looking at it or feeling it. A biopsy can provide this information.

Types of biopsy

There are various types of biopsy that can be used to help identify a wide range of health conditions. Types of biopsy include:

• scraping cells – removing cells from the surface layer of tissue, such as from the inside of the mouth or from inside the cervix (neck of the womb), as part of a cervical screening test
• a punch biopsy – is for diagnosing skin conditions using a special instrument to punch a small hole in the skin to obtain a skin sample
• a needle biopsy – a special hollow needle, guided by ultrasound, is used to obtain tissue from an organ or from tissue beneath the skin
• an endoscopic biopsy – where an endoscope is used to remove tissue, such as from the stomach during a gastroscopy (a diagnostic procedure of the stomach or upper gastrointestinal tract)
• an excisional biopsy – where surgery is used to remove a larger section of tissue
• perioperative biopsy – if consent has been given, a perioperative biopsy can be carried out during surgery; the sample will be tested straight away so that the surgeon can be given the diagnosis and provide appropriate treatment

How a biopsy is carried out will depend on where the tissue sample is being taken from. CT scanning is often used to guide some types of biopsy.

After the tissue sample has been removed, it will be examined under a microscope to see whether it’s abnormal. If it is, the aim is to identify the nature of the problem. This often means that a definite diagnosis is made.

The tissue may be tested using various chemicals to see how it responds and to find out what it contains. The type of tests used will depend on the medical conditions being investigated.

Read more about why you might need a biopsy.

Recovery

Most biopsies will only require local anaesthetic, which means that you won’t need to stay in hospital overnight. However, a general anaesthetic may be needed for surgery, in which case you may have to stay in hospital overnight.

Most types of biopsy are painless, although this depends on where from your body the sample is taken. You may experience a dull ache which can be treated with painkillers on the advice of your doctor or surgeon.

Some types of biopsy may involve staying in hospital for a few hours. You may need to have stitches or a dressing applied before you leave.

Read more about recovering from a biopsy.

Getting your results

How quickly you get the results of a biopsy will depend on the urgency of your case and the hospital where you had the procedure.

If a serious condition is suspected, your results may be available within a few days. However, this is difficult to predict because further tests may be needed after the first examination of the sample. Sometimes it is also necessary to send microscope slides away to get a specialist’s opinion. A cervical smear test result usually takes 10-14 days.

A different processing method is used when a biopsy is carried out during surgery. This means the result is often available within minutes, which enables the appropriate treatment to be given while the surgery is in progress.

Your GP, hospital consultant or practice nurse will give you your results and explain what they mean. Sometimes, a biopsy will be inconclusive, meaning it hasn’t produced a definitive result. If this is the case, the biopsy may need to be repeated or other tests may be needed to double-check your diagnosis.