Biopsy

What is a biopsy?

The basic process of biopsy involves removing a sample of tissue or some cells from your body to examine them for any particular disease. In case any segment of the body is suspected of not being normal, the doctor orders for a biopsy.

The segment can be a mass, a tumor or any abnormal tissue which has been detected either by a physical examination or through a scanning process. It can be taken from any body part including the skin, stomach, kidneys, liver, lungs and even the brain.

The process of sample collection depends on the area in which the biopsy will be conducted. In some cases, a tissue sample can be removed by using a thin needle or through an endoscope. In other severe cases, the surgeons can remove entire organs for a necessary biopsy. In various other cases, biopsies are performed along with imaging methods like ultrasound, x-ray, CT or MRI for proper guidance about placing the needle in the right location.

Why do I need to undergo a biopsy?

A biopsy is generally done when cancer is suspected in the body. In addition, it is also used to diagnose a wide variety of other conditions. In some situations, a biopsy of a normal tissue sample is also done to check cancer spread or the body’s rejection of a transplanted organ. The following are some of the reasons for the conduction of a biopsy.

– Abdominal biopsy is done when an abnormal lump or growth is detected in the abdominal tissue.

– In case any lump or mass is detected through a mammogram, indicating and cancerous development in the breast.

– A mole on the skin that has changed shape or color and may develop into melanoma.

– A bone biopsy is used to diagnose cancer or infection in the bone and a sample is taken from the bone.

– Bone marrow biopsy can also be done in case leukemia is suspected.

– In case a person has an infection in the liver or in the case of chronic hepatitis wherebiopsy can detect the presence of cirrhosis.

– An endometrial biopsy can be used to detect abnormalities in the uterus or to check abnormal bleeding.

– A biopsy of the kidney can be used for the analysis of kidney failure, any inflammation in the kidney or a suspected tumor.

– A lung or chest nodule biopsy is done to check any abnormal growth in the lungs.

– A muscle biopsy is used to study any defects in the muscle and diseases of the connective tissue.

– Testicular biopsy is used if any cancerous growth is suspected in the testicles.

Biopsies can be done on almost any organ including the heart, thyroid, bladder and even the nerve endings for a detailed examination of an area of concern.

What are the different types of biopsies?

There are several types of biopsies and some of the major ones are described below.

Needle biopsy– A needle biopsy can be classified into fine needle biopsies and core needle biopsies. The former uses a hollow needle through which fluid from the body is extracted into a syringe. The later method used a slightly larger needle to extract a small cylindrical sample of tissue.

Endoscopic biopsies- This method is used to reach inside the organs like the bladder, colon, or lung to extract a tissue sample. A flexible thin tube called an endoscope is inserted through the mouth, nose, rectum, or urethra. It can also be inserted by making an incision. The endoscope contains a tiny camera, a light at the end and also surgical tools attached to it.

Surgical biopsies- In some cases, certain internal organs cannot be reached by the use of the methods listed above. For such situations, the surgeon has to make an incision and remove a portion of the tissue and submit it for biopsy. Laparotomy is also a particular method where surgery is done to collect a sample from the abdominal area. A similar procedure is openly conducted in the chest and is termed as thoracotomy. Often, the process is also carried out in the midst of surgery when the pathologist inspects some particular cells and informs the surgeon within a few minutes.

Bone marrow biopsy- This method is used to extract a sample of the bone marrow by inserting a large needle into the hip bone or the lower sections of the spine.

How is a biopsy performed?

You will be instructed by the doctor about the necessary steps that are to be taken before the biopsy. The time required for the process depends on the process of the biopsy and the area on which it is conducted.

– The process may make use of one or more of the instruments like syringes, sponges, forceps, scalpels, specimen cups and a vacuum-assisted device. In addition, it may also need to be assisted by an ultrasound or a CT scan.

— You will be asked to lie down if needed andprovided with an anaesthetic depending on the method to prevent any sensation of discomfort or pain.

– Sedation or relaxation medication can also be administered if necessary. After the process is complete pressure is applied on the collection point to stop any bleeding and it is covered with a dressing.

– Depending on the process, you might be able to leave immediately or kept under observation for several hours.

– After the biopsy is done, a pathologist, who is an expert about the cells, tissues and organs, looks into the specimen through a microscope.

– The process involves the preparation of glass slides in which very thin sections of the specimen are stained with various dyes.

– Different sections of the cell are dyed with different colours to make observation easier. A slide can be made by using a permanent section with the help of formalin and paraffin wax.

– It can also be of a frozen section where the specimen is quickly frozen after a surgery. There are also smears that are used when the specimen is a liquid or if small pieces of tissue are present.

What is the price for a biopsy in India? 

The price of a biopsy in India, depends on the area, the process required and the facilities provided in the clinic. The costs may range from Rs 500 to Rs 10,000.

How fast is the prevalence of cancer increasing in India?

Cancer is the second leading cause of death worldwide; with more than 8 million people succumbing to this deadly disease every year. In India, poor air quality, unhealthy diet, and poor lifestyle choices are causing a sharp increase in the number of cancer cases reported annually. As per the latest studies, in the year 2016, there were almost 1,400,000 cases of cancer reported in India in a single year. Since 2012, the mortality rate of cancer has increased by 6%.

When will I get the test results?

The results for minor biopsies are generally delivered within two days. In some cases, more time may be required to study a specimen depending upon the specific situation.

What is the normal range for a biopsy?

The pathologist generally examines, both visibly and under the microscope, the following points in a specimen.

– The type of cells.

– The structure and arrangement of the cells as the growth of cancerous cells is not in coordination with healthy cells.

– Any abnormality in the cells, specifically that of the cell nucleus.
Any specific element in the tissue.

– Classifying the type and grading of cancer.

– In some cases, gene or protein tests may be required to find out the necessary mode of treatment. The final report from the pathologist will be delivered to the doctor who will analyze and discuss the details of the report with you.

What do the results mean?

The results of a biopsy can vary depending on the observation. In some cases, the cells can be described as atypical, which indicates that while they are not normal, they are not cancerous. Cancerous cells can be described in the report as carcinoma, sarcoma, lymphoma, leukemia, neoplasia, etc.

If the report is interpreted as cancer, the doctor will be able to classify cancer and state its level of aggression. In case the symptoms belong to some other disease apart from cancer, a treatment plan for the same will be formulated. In some cases molecular or genetic tests can be ordered to look for specific genetic changes in the cells.

Do I need to fast for the biopsy?

The requirements for a biopsy varies depending on its nature. Your doctor will be able to guide you on the specific steps to be taken before the procedure.

What else do I need to know before I appear for a biopsy?

A biopsy is a safe procedure that is not very painful and provides accurate results. In some cases, the process can be invasive and the recovery time can be longer. There are always some minor chances of excessive bleeding and infection in the collection point. In case of such incidents, treatment might be necessary.

It is also best to inform your doctor about the medicines and supplements you are consuming before a surgical biopsy.

Can pregnant women undergo a biopsy?

Pregnant women can undergo biopsy when it is recommended by a doctor.

Is biopsy possible for new-born babies?

A biopsy is possible for new-borns and it is generally conducted by using general or local anesthesia.