A biopsy is a medical procedure that involves taking a small sample of tissue so that it can be examined under a microscope. The term biopsy is often used to refer to the act of taking the sample and the tissue sample itself.

The main types of biopsy

A tissue sample can be taken from almost anywhere on (or in) your body, such as your skin, stomach, kidneys, liver, and lungs. A number of different types of biopsy can be used to help identify a wide range of different health conditions. Types of biopsy include:

1. 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),

2. a punch biopsy – for diagnosing skin conditions,
3. a needle biopsy – for obtaining tissue from the body’s organs, or from tissue underneath the skin,
4. an endoscopic biopsy – where a medical instrument known as an endoscope is used to take a tissue sample,
5. a capsule biopsy – used when a sample from the intestine lining needs to be taken, and
6. an excisional biopsy – where surgery is used to take a larger section of tissue.

How the biopsy is carried out will depend on where the tissue sample is being taken from. See the post on how biopsy is carried out for further information about the different types of biopsy and how they are performed.

The use of a biopsy

Biopsies are used to identify abnormal cells. The result of a biopsy can often help to diagnose a wide range of conditions including cancer, peptic ulcers (ulcers that affect the digestive system), hepatitis (inflammation of the liver), kidney disease, and endometriosis (where cells that usually line the womb are found elsewhere in the body).

Biopsies are commonly used to check whether a breast lump is benign (non-cancerous) or malignant (cancerous). After the tissue sample has been taken, the cells will be closely examined under a microscope to see whether or not they appear abnormal, and to check for any unusual cell activity. The cells may also be tested using various chemicals to see how they respond. The type of tests that are used will depend on the medical conditions that are being investigated.

Biopsies are used to investigate the cause of a person’s symptoms, or to confirm a diagnosis that they already suspect due to other test results. A biopsy can also be used to measure the severity of a condition. For example, how severely an organ, such as the liver, is inflamed. Biopsies are used to diagnose a wide range of health-related conditions, including cancer. If you have a lump, or growth, on your skin, or inside your body, it is impossible to tell whether it is malignant (cancerous) or benign (non-cancerous) just by looking at it, or feeling it. A biopsy will be able to provide that information.

Testing a tissue cell sample

After a tissue sample has been taken, it will be sent to a laboratory so that it can be examined under a microscope and the tissues cells can be tested. Cells are the building blocks that make up your body. By closely examining them, scientists can see whether they are normal or abnormal. Cancerous cells, for example, look and behave differently from normal cells. As well as a visual examination, chemical, or genetic, tests can also be carried out on the tissue sample. For example, a chemical test is sometimes used to diagnose cystic fibrosis, which is an inherited condition where thick secretions are produced in the lungs, making breathing difficult. If the gene for cystic fibrosis is present in the cells, a chemical reaction will occur.

Tests for cystic fibrosis and other genetic conditions can even be carried out on a cell sample that is taken from an unborn baby. The cell sample is taken from the placenta using a pre-natal biopsy called chorionic villus sampling (CVS). During CVS, a small piece of the placenta is removed using a very fine needle that is passed through the abdomen (stomach) using ultrasound to guide it. Once a cell sample has been obtained, a chromosome (genetic) analysis will be carried out to determine whether the gene that is responsible for cystic fibrosis is present.

Biopsy results

How quickly you get the results of your biopsy will depend on the hospital where you have had the procedure and the urgency of your case. It usually takes between 10-14 days for a pre-natal biopsy called chorionic villus sampling (CVS) test results to become available. The results can be used to help parents decide whether they wish to terminate a pregnancy or continue with it. See the useful links section for more information about cystic fibrosis and CVS.

The results of routine cervical smear tests usually take between 10-14 days to become available, while the results of biopsies that are carried out because your doctor suspects a serious condition, such as cancer, may be available within a few days. In cases where a biopsy is performed during surgery, a result is often available within minutes so that the right treatment can be given while the surgery is in progress.

Your doctor, hospital consultant, or practice nurse, will give you your results and will explain what they mean. Sometimes, a biopsy will not be conclusive, which means that it has not produced a definitive result. If this is the case, the process may need to be repeated, or you may require further tests in order to double-check your diagnosis.

Recovering from a biopsy

Biopsies are usually straightforward procedures that can often be carried out as outpatient procedures using local anaesthetic. In such cases, you will not need to stay in hospital overnight. Some types of biopsy, such as those that involve taking a tissue sample from an internal organ, will require a general anaesthetic. If you need to have a general anaesthetic, you may need to stay in hospital overnight.

After having a biopsy, you will not usually experience any pain. However, if you have had a sample taken from a major organ, such as your liver, or from your bone marrow, you may have a dull ache, or a slightly uncomfortable feeling. Your doctor, or surgeon, will be able to advise you about the painkillers that you can take in order to relieve this. If an incision (cut) is required in order to remove a tissue sample – for example, during an endoscopic biopsy, or an excisional biopsy – the wound may need to be closed using stitches, or you may need to have a dressing put on the wound.

If you have had a biopsy where tissue has been taken from an important organ, such as your liver, or kidneys, you will need to stay in hospital for a few hours after the procedure. This is so that you can rest and hospital staff can ensure that there is no internal bleeding. It is very rare for serious bleeding to occur following a biopsy but, if it does, you may need to have an operation or a blood transfusion.

Women who have had samples taken from their reproductive system, such as their womb lining, or cervix (neck of the womb) may experience a little light vaginal bleeding. Men who have had a prostate biopsy may have blood in their urine.

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