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You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors that care for people with cancer.

Today we’ll discuss what you can expect if you are scheduled for a biopsy.

A biopsy is a medical procedure that gives an analysis of tissue in the body that a doctor suspects may be a tumor. For most types of cancer, a biopsy is the only way to make a correct cancer diagnosis. Often, doctors will recommend a biopsy after a possible tumor is found during a physical exam or imaging test. During the biopsy, the doctor removes a small piece of tissue, called a sample, to be examined under a microscope. The sample is then analyzed by a pathologist, who is a doctor that specializes in interpreting lab tests and evaluating cells, tissues, and organs to diagnose disease. After looking at the tissue, the pathologist determines whether the sample contains a tumor. Also, a biopsy can show whether the tumor is benign, meaning noncancerous or malignant, which means it’s cancerous and can spread to other parts of the body.

Depending on the type of biopsy and where on the body it needs to be done, it can be performed in your doctor's office, or you may need to stay in the hospital if surgery is required. For example, the type of biopsy you need and where it’s done is different if the tissue needs to be taken from your skin, compared with an internal organ, which may involve a more invasive procedure.

There are several different ways to take a biopsy sample. Many involve using a hollow needle to pull out a sample of cells or fluid. The needle used for a biopsy may be thin, such as with a fine needle biopsy, or slightly thicker, often called a core needle biopsy. The doctor may also use suction to help collect a sample, called a vacuum-assisted biopsy, or use imaging tests to help guide the needle to the correct location, called an image-guided biopsy. A biopsy can also be done during surgery, called a surgical biopsy, which may involve the removing all or part of a tumor. An endoscopic biopsy uses the thin, lighted, flexible tube to get a sample from the gastrointestinal tract. Lastly, a bone marrow biopsy takes a sample from the spongy tissue of the inner part of large bones with a needle.

Because there are many types of biopsies, the medical team may be different depending on the procedure. Talk with your doctor about who will be performing your biopsy. Sometimes an operation will be required, so a surgeon will perform it, but other types of biopsies using just a needle can be done by other doctors.

Next, we’ll talk the steps you can take to prepare for a biopsy. These steps might be different, depending on the type of biopsy you’ll have. For example, you may not need to prepare much for a fine needle biopsy that happens in your doctor's office. On the other hand, you’ll likely need much more preparation for a surgical biopsy.

When you are first scheduled for a biopsy, be sure to ask your doctor or nurse whether you can eat or drink anything before your biopsy, and ask if you should take your regular medications that day. In addition, let your doctor know about all medications and supplements you’re taking, as well as any drug allergies or other medical conditions you may have.

Before your biopsy, your doctor or nurse will explain the procedure to you, and you’ll be asked to sign a consent form that says you understand the benefits and risks of the biopsy and agree to have the test done. You can always talk with your doctor about any concerns you may have before the procedure.

Now let’s discuss what you might expect during a biopsy.

Depending on where on your body the biopsy is needed, you may be lying on your stomach or back or sitting up. During a procedure using a needle, your doctor may ask you to hold your breath while it is inserted, and it’s important to be very still during the procedure.

Different types of medications, such as anesthetics, are used to block the awareness of pain. However, you may feel a small amount of pain or discomfort during some types of biopsies. This may include slight or stinging pain when a local anesthetic is injected to numb the area or pressure and dull pain when the biopsy needle is inserted. Because you may need to lie still for a long time, you may feel discomfort or soreness after the procedure. If a general anesthetic is used, you won’t feel pain during the procedure because you’ll not be aware of the procedure.

After your biopsy, how long it takes for you to recover depends on the type of biopsy performed. For less invasive procedures no recovery time is needed, so you’ll be able to go back to your normal activities immediately. If you have a surgical biopsy, you’ll be watched closely by your healthcare team immediately after the procedure, and you may need to stay in the hospital to recover. Make sure to talk with your doctor or nurse about how to best take care of the area after the procedure is over. In addition, be aware of any symptoms that might suggest that something is wrong. Contact your doctor if you experience signs of infection, severe pain, fever, or bleeding.

Finally, let’s talk about getting the results back from the biopsy. The amount of time it takes for you to receive the results of a biopsy may vary depending on what the pathologist sees in the tissue sample. A straightforward and uncomplicated result is usually given within two to three days after the biopsy, while a more complicated result can take up to seven to 10 days because the pathologist may need to do additional tests. Talk with your doctor about how you will receive the results of your biopsy and who will explain these results to you. 

Before having a biopsy, consider asking your doctor the following five questions, along with discussing any concerns you may have about the test:

Question number one: Who will perform the biopsy and what will happen during the procedure?

Question two: How long will the procedure take and will it be painful?

Question number three: Will I need to stay in the hospital or avoid any activities afterwards, such as driving myself home?

Question four: How do I need to prepare for the biopsy and are there any restrictions on what I may eat or drink the day before?

Lastly, question five: When and how will I get the results of the biopsy, and who will explain them to me?

Now that you know what to expect before having a biopsy, you’ll hopefully feel more comfortable with having this important test.

For more information on getting a biopsy, talk with your doctor or visit www.cancer.net. Cancer.Net is supported by the Conquer Cancer Foundation, which is working to create a world free from the fear of cancer by funding breakthrough research, sharing knowledge with physicians and patients worldwide, and supporting initiatives to ensure that all people have access to high-quality cancer care. Thank you for listening to this Cancer.Net podcast.

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