How is Biopsy done?

By  , Expert Content
Sep 03, 2012

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Biopsy is an invasive medical procedure in which a sample of a tissue or cell is taken to be examined by a pathologist, usually under a microscope. Tissue sample for biopsy can be obtained in different ways. The procedure used to take tissue sample depends on the type of tissue that is being collected and where in the body it's being taken from.

Scraping cells

In some cases, scraping cells from the surface layer of a tissue can provide enough samples for diagnosis. Scraping biopsy is the least invasive type of biopsy. Although it can cause some discomfort, it's not painful; therefore,  anaesthesia isn't required. Scraping biopsy can be useful to take sample to diagnose many conditions, such as cervical screening test to diagnose cervical cancer or lesions in mouth.

Punch biopsy

Punch biopsy is most often performed to diagnose diseases of the skin, such as deep spots and sores. In this type of biopsy, a special surgical instrument is used to make a small hole in the skin and a sample of tissue is taken from the top layers of the skin. Since it is a painful procedure, you will be given a local anaesthetic to numb the area. Another way of doing punch biopsy is by using a scalpel (a sharp medical knife). In this method, a small amount of surface skin is removed and the wound is closed using stitches. As with a punch biopsy, you will be given a local anaesthetic to numb the area.

Needle biopsy

When a sample of tissue has to be taken from organs or lumps that are below the surface of the skin, needle biopsy may be used. This procedure may be done using a fine-needle aspiration (FNA) biopsy or core needle biopsy (CNB). A core needle biopsy (CNB) is generally used when a larger sample is needed. The needle is hollow and after it is inserted in the right position, it will ‘suck out’ a sample of a tissue. If needed, your doctor will do the procedure using ultrasound or X-rays. A local anaesthetic is given before the procedure so that you don't feel any pain or discomfort. A needle biopsy is useful to take a sample of a tissue from the breast and organs, such as the liver or kidneys.

Bone marrow

Bone marrow biopsy is done using a thick needle. Bone marrow is a soft, jelly-like tissue that's found in the hollow centre of all the large bones. Bone marrow biopsy is useful to diagnose many conditions including leukaemia (cancer of the bone marrow and white blood cells) and stage cancer. In most cases, bone marrow biopsy is taken from the pelvic bone (bone in your waist). Local anaesthesia is given to numb the area and if needed, a sedative (medication) may be given to help one relax and cope with any discomfort and anxiety.

Endoscopic biopsy

Biopsy from an internal organ may be taken when endoscopy is done. Endoscope is a special medical instrument, which has a thin and flexible tube with a light and camera at one end. It can be inserted through the throat, anus or small cuts made by the surgeon. Depending on the site where endoscope is inserted and the procedure, either local or general anaesthetic may be used.

Excisional biopsy

During excisional biopsy, a larger area of the tissue, such as a lump, is removed by surgery for closer examination. It may be performed under either a local or general anaesthetic depending on site from where the sample is taken.

Perioperative biopsy

Biopsy can be taken when surgery is being done for another, unrelated reason.'


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