Approved by the Cancer.Net Editorial Board, 10/2021

Your doctor may recommend a biopsy if they think you might have cancer. In a biopsy, a doctor takes a small amount of tissue from the area of the body where cancer may be present. The tissue is sent to a laboratory and examined under a microscope for cancer cells by a specialist called a pathologist. Other tests can suggest that cancer is in the body, but only a biopsy can test to show whether there are cancer cells.

What are the different types of biopsy?

The type of biopsy you have depends on where the possible cancer is located.

Needle biopsies. This general category refers to different biopsies, each using a special needle to collect cells to test an area for cancer.

For instance, in a fine needle aspiration biopsy, the doctor inserts a very thin, hollow needle through the skin to collect a sample of cells and sometimes fluid for examination. This is the most simple type of biopsy. It is often used when a mass can be felt through the skin. A core needle biopsy uses a larger needle to remove a larger tissue sample than a fine needle biopsy. A vacuum-assisted biopsy uses a suction device to collect a tissue sample through a specially designed needle. Your doctor can collect multiple or large samples from the same biopsy site with this method.

Image-guided biopsy. This type of biopsy uses imaging equipment to help your doctor take the sample. You might have this if your doctor cannot feel a tumor, or it may be deeper inside the body. Sometimes, even if a tumor is large enough to feel, image-guided biopsy can be used to help direct the doctor to the right part of the body. This helps the doctor do the biopsy in the safest way possible. The imaging equipment may be:

Needle biopsies, such as a core needle biopsy and vacuum-assisted biopsy, can be done with imaging equipment, if needed.

Surgical (excisional) biopsy. This type of biopsy is done using surgery to remove the tissue your doctor thinks may be cancer. The surgeon makes an incision (cut) into the skin to remove the suspicious tissue. The complexity of the surgery depends on the area of the body involved.

Shave biopsy/punch biopsy. For a shave biopsy, the doctor removes some tissue by scraping the surface of the skin. In a punch biopsy, they use a small circular instrument to push through the surface of the skin and take a sample of tissue from below the skin's surface. These are used most commonly for a skin biopsy.

Endoscopic biopsy. An endoscope is a thin, lighted, flexible tube with a camera that allows doctors to view the inside of the body, including the esophagus, stomach, bladder, and joints. The endoscope goes in through the mouth, nose, or a small incision in the skin. The attached camera helps the doctor see any abnormal areas. Your doctor can also take tissue samples for a biopsy. Learn more about the different endoscopic techniques.

Laparoscopic biopsy. Similar to an endoscopic biopsy, this type of biopsy is used to examine for certain areas of the body, including the abdomen or pelvis. When used for the chest, it is called a thoracoscopy or thoracoscopic biopsy. In this type of biopsy, the doctor inserts a thin tube with a video camera called a laparoscope into the abdomen through small incisions. This allows the doctor to see abnormal areas and take tissue samples for examination.

Bone marrow aspiration and biopsy. Bone marrow is the soft tissue and liquid inside your bones. The aspiration takes a small sample of the liquid with a needle, while the biopsy takes a sample of solid tissue. A bone marrow aspiration and biopsy is done to check for a blood disorder or blood cancer, such as leukemia, lymphoma, or multiple myeloma. Bone marrow aspiration and biopsy are often taken from the pelvic bone. This is on the lower back, near the hip.

Liquid biopsy. Testing a blood sample for cancer is called a liquid biopsy. You give a small sample of blood, and it is sent to the lab for specific tests. It can also show how cancer is responding to treatment. A liquid biopsy has less risk than taking a sample of tissue, and your doctor can do it multiple times. However, this type of biopsy is still new and it is not done for most types of cancer. There is a lot of research ongoing to expand usage of this technique.

This information is based on
a joint review of liquid biopsy research by ASCO and the College of American Pathologists. Please note that this link takes you to another ASCO website.

Who does a biopsy and who analyzes the sample?

Who does your biopsy depends on the type of procedure recommended and what area of the body is being tested. Biopsies can be done by different medical professionals, including:

  • A surgeon

  • A radiologist, who specializes in taking and reading medical images

  • An oncologist, who specializes in treating cancer

  • A gastroenterologist, who specializes in the digestive system

  • A pathologist, who specializes in looking at tissue samples for disease and interpreting laboratory tests

  • A cytologist, who specializes in the study of cells and may do a fine needle aspiration.

  • A dermatologist, who specializes in skin conditions

  • A gynecologist, who specializes in women's health

  • A family practice doctor or other specialists

  • Some biopsies may also be done by physician assistants and nurse practitioners

Getting ready for a biopsy

You may be wondering what you will need to do at home to prepare for your biopsy. This depends on several factors, starting with the type of biopsy. For example, you will not need to do very much to prepare for a fine needle biopsy in your doctor's office. You might need to remove your clothing and jewelry and put on a hospital gown after you arrive. Other types of biopsy will may require additional preparations in advance.

A member of your health care team will explain the procedure to you. Be sure to review any preparation materials your doctor's office gives you before your test and ask questions about anything that is not clear. Talk with your doctor about any concerns you have before the biopsy.

Here are some common questions and concerns:

  • Ask whether there are restrictions on what you can eat or drink before the biopsy. If there are restrictions, ask for how long beforehand.

  • Ask if you should take your regular medications that day. For certain biopsies, your doctor will want to know if you are taking blood thinners or aspirin. Tell your doctor about all medications and supplements you are taking.

  • Tell your doctor about any allergies or other medical conditions you have.

  • Be sure you understand where the biopsy will take place. If it is at a different location than your doctor's office, be sure to talk with that location about your health insurance coverage for the test.

  • You will be asked to sign a consent form saying you understand the benefits and risks and agree to have the biopsy. Ask any questions you may have about this legal form.

  • Being nervous about an upcoming medical test is common and is sometimes called scanxiety. If you feel very worried, talk with your health care team about ways to cope with these feelings.

  • Ask what to expect about your recovery after the test.

During your biopsy

Depending on the part of your body being checked, you might lie down or sit up. You might need to hold your breath or stay still. Your health care team will let you know what to expect.

Before the procedure, you may receive a type of anesthesia to block the awareness of pain. The type depends on biopsy and where it is done. You may have local anesthesia to numb the area, conscious sedation, or general anesthesia.

After your biopsy

Your recovery period will depend a lot on the type of biopsy done. You might be able to go back to normal activities as soon as the test is over. Or you may need to rest at home for some time or stay in the hospital to begin your recovery. If your anesthesia includes a sedative, you need someone to drive you home afterwards.

Talk with your doctor or nurse about how you should take care of the biopsy area during your recovery. Contact your doctor’s office if you experience:

  • Redness or swelling in the area where the biopsy was done

  • Severe pain

  • Fever

  • Bleeding

Getting your biopsy results

When and how you will get your results are important questions to ask your doctor before the test. The results, called a pathology report, may be ready as soon as 2 or it may take as long as 10 days. How long it takes to get your biopsy results depends on how many tests are needed on the sample. Based on these tests, the laboratory processing your sample can learn if cancer is present and, if so, what type it is.

Ask your doctor how you can expect to get your biopsy results and who will explain them to you. For example, ask whether you should schedule a follow-up appointment for when your doctor will share the results in person, or if you will be called or emailed. Also ask if your pathology report will be available on an online patient portal. Knowing in advance how and when your results will be provided to you can reduce anxiety and help you feel more comfortable.

Questions to ask your health care team

Before having a biopsy, you may want to ask your doctor the following questions:

  • Why do you recommend I have a biopsy?

  • What are the risks of not having one?

  • When will I get the results of the biopsy? How will I get the information? Who will explain the results to me?

  • Can you describe what it is like having this biopsy?

  • Who will do the biopsy?

  • How long will it take?

  • Will it hurt? What are my options for anesthesia and other pain relief, if needed?

  • How do I need to get ready for this test? Should I stop eating, drinking, or taking certain medications before the biopsy? For how long?

  • If I'm very worried or anxious about having this test, what are some ways to cope with the stress?

  • What will my recovery be like? Do I need to stay in the hospital after the biopsy?

  • How should I take care of the biopsy area afterward?

  • What are the risks of bleeding, infection, or other problems after the biopsy?

  • Will I have a scar?

  • Will I need to avoid any activities after the biopsy? For how long?

  • Do I need someone to drive me home?

  • Where will my biopsy be done?

  • What is my health insurance coverage for this test?

  • How can I get a copy of my pathology report for my personal medical records?

  • Depending on the biopsy test results, could I need other tests or procedures?

Related Resources

Biopsy: 5 Things Every Patient Should Know

After a Biopsy: Making the Diagnosis

Spotlight On: Pathologists

Diagnosing Cancer

Preparing Your Child for Medical Procedures

More Information

College of American Pathologists: How to Read Your Pathology Report