What is a Biopsy Procedure?

A Biopsy test involves removing cells or tissues to check under a microscope. Doctors may recommend a biopsy if an initial test suggest that an area of tissue in the body is not functioning normally. It helps to determine the presence or extent of a disease. The subject tissue is generally examined under a microscope or can also be analyzed chemically.The area of abnormal tissue is called a lesion, a tumor, or a mass. These are general words, used to feature the unknown nature of the tissue.

There are 3 main kinds of biopsies:

Incisional Biopsy or Core Biopsy: By this type only a sample of tissue is removed.Needle Biopsy or Biopsy or Fine-Needle Aspiration: A sample of tissue or fluid is removed with a hollow needle.Excisional Biopsy: A whole tumor or lesion is removed.

Biopsies are done in order to detect the suspicious area either during a physical examination or inside the body on an imaging test. Although it is carried out for cancer diagnosis; however, biopsies also help to identify many other conditions. In some cases, a biopsy of normal-appearing tissue may also be done to check for cancer spread or rejection of a transplanted organ.

In most cases, a biopsy is done to diagnose a problem or to help determine the best therapy option. This can be done through numerous different ways. Nearly all of them involve using a sharp tool to remove a small amount of tissue.

Here are some types of biopsies:

Needle biopsy: As described above, in this type, a slightly larger, hollow needle is used to access the suspicious tissue.CT-guided biopsy: A procedure in which a person rests in a CT-scanner; images taken from the scanner help physicians determine the exact position of the needle in the targeted tissue.Bone marrow biopsy: Involves the use of large needle to detect blood disease such as leukemia and lymphoma. Needle is injected in the pelvis bones to collect bone marrow.Liver biopsy: Removal of small sample of tissue from the liver by inserting needle into the liver through the skin on the belly, and tissues of the liver are captured.Prostate biopsy: Multiple needle biopsies are taken at one time from the prostate gland to detect the presence of cancer. In this procedure, a probe is inserted into the rectum to access the prostate.Surgical biopsy: Either open surgery or laparoscopic surgery may be required to obtain a biopsy of hard-to-reach tissue.

Once the test is done, the tissue is collected and preserved in a diagnostic histopathology setup. It is then provided to a pathologist at a pathology laboratory. Pathologists are doctors who specialize in diagnosing conditions based on tissue samples and other tests. A pathologist examines the specimen under a microscope and by carefully observing the tissue cell's type, shape, and internal activity (in most cases) a pathologist can diagnose the problem and disclose the results to the concerned doctor.

The time it takes to get results from a biopsy can vary. Sometimes, highly accurate conclusions on biopsies often take a week or longer but in an emergency case, a pathologist may read a biopsy and report back to a surgeon in a few minutes. This is done by a biopsy procedure called the frozen section. During the frozen section procedure, the physician removes a small portion of the tissue mass. The pathologist freezes the tissue in a cryostat machine, cuts the tissue with microtome, and then stains it with various dyes so that it can be examined under the microscope. As soon as the diagnosis is made, the results are communicated to the surgeon.

Biopsies are important to study the health issues people face during their lifetime, without a it, the doctors may not be able to diagnose or treat deadly diseases such as cancer, tumors, etc.

Author: Dureshahwar Memon is a human rights activist and holds keen interest in Nature photography. She is an animal lover, enjoys music and is a fun person to be with. She is a new blogger and is currently working as Media Officer at Chughtais Lahore Lab. Follow her on Twitter @DureshawarMemon
Diagnostic Histopathology | Bone Marrow Biopsy

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Sentinel Node Biopsy Safe and Effective for Breast Cancer

Among women with early breast cancer and no evidence of cancer in the sentinel lymph nodes, sentinel lymph node biopsy alone is as effective as more extensive lymph node surgery. These results were presented at the 2010 annual meeting of the American Society of Clinical Oncology.

For women with early breast cancer, determining whether the cancer has spread to the axillary (under the arm) lymph nodes is an important part of cancer staging. Evaluation of the axillary nodes may involve either an axillary lymph node dissection (ALND), in which many lymph nodes are surgically removed and evaluated, or a less extensive procedure known as a sentinel lymph node biopsy.

The sentinel nodes are the first lymph nodes to which cancer is likely to spread. A sentinel lymph node biopsy involves the removal of only these nodes. If cancer is found in the sentinel nodes, most women undergo additional lymph node removal. If the sentinel nodes are free of cancer, however, women may not require any additional lymph node removal. Avoidance of extensive lymph node removal reduces the risk of side effects such as lymphedema (swelling).?

To explore whether the two approaches to lymph node evaluation (sentinel lymph node biopsy and axillary lymph node dissection) produce similar breast cancer outcomes, researchers conducted a study among 5,611 women with operable, clinically node-negative, invasive breast cancer. Study participants were assigned to sentinel lymph node biopsy and axillary lymph node dissection or sentinel lymph node biopsy alone (with axillary lymph node dissection only if the sentinel node was positive).

Seventy-one percent of the study participants had negative sentinel lymph nodes and have been followed for an average of close to eight years.

Compared with women who underwent axillary lymph node dissection, women who underwent sentinel node biopsy alone had similar rates of breast cancer recurrence and overall survival. Women who underwent sentinel lymph node biopsy alone had lower rates of side effects from lymph node removal.

These results suggest that when the sentinel lymph node is negative, sentinel lymph node biopsy alone (with no additional lymph node removal) is safe and effective.

Reference: Krag DN, Anderson SJ, Julian TB et al. Primary outcome results of NSABP B-32, a randomized phase III clinical trial to compare sentinel node resection (SNR) to conventional axillary dissection (AD) in clinically node-negative breast cancer patients. Presented at the 2010 annual meeting of the American Society of Clinical Oncology. June 4-8, 2010. Chicago, IL. Abstract LBA 505.

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