A biopsy is a medical examination of body tissue for certain diseases, which is taken for this purpose. Tissue samples can be taken from all body parts/organs.
What is a biopsy?
In medicine, biopsy is the removal and examination of tissue from humans. The removed biopsy specimen is examined by the pathologist under a microscope. Tissue removal or biopsy is usually taken from tumors with the help of a special needle. The needle is inserted directly through the skin without an incision. A distinction is made between punch biopsy and fine needle biopsy. In both types of biopsy, the hollow needle is guided to the tumor under local anesthesia and the suspicious cells are removed. In order to obtain sufficient cell material for a diagnosis, the hollow needle must be brought to the tumor several times in this variant of the biopsy. The punch biopsy is performed in almost the same way, but with needles that have a larger diameter. Such needles can be used to remove smaller pieces of tissue and not just individual cells. However, even with this type of biopsy, further removals are useful, as this provides sufficient tissue mass for examination.
Function, effect, and goals
A biopsy is by no means the very first step in the diagnostic chain. For example, if cancer is suspected, ultrasound or magnetic resonance imaging is performed first. However, a biopsy can be used to diagnose a suspected disease more reliably, since the tissue is taken directly from the suspected area. Apart from punch and fine needle biopsy (puncture), vacuum biopsy is also used. In this case, tissue is removed by means of a hollow needle, inside of which a vacuum is present. Such biopsies are used for breast tissue, for example. Suspicious tissue can also be cut out using a scalpel (excision biopsy) or special instruments such as snares, brushes or forceps (endoscopic biopsy). The most common biopsies are, for example: liver biopsy, which is used to monitor the progress or diagnosis of various liver diseases. A biopsy of the prostate is performed if malignant prostate changes (prostate carcinoma) are suspected. A uterine biopsy, which can be helpful in the case of suspicious changes in the cervix (cervical carcinoma). Cell smears are taken specifically from the suspicious area. Often, surgery (conization) is necessary to remove a cone-shaped sample from the uterus. In the case of a biopsy of the breast (mammabiopsy), the suspicious tissue is usually obtained by a punch biopsy. If malignant skin tumors (melanomas) are suspected, excision is performed, whereby the tumor is cut out with a certain safety distance. In this way, the attending physician removes the entire tumor tissue with the greatest possible probability. Even before a biopsy, some important aspects must be taken into account. During an organ puncture (fine needle biopsy) in the area of the abdomen, the person concerned must always be fasting, so he or she must not drink or eat anything for several hours before the treatment. If the person has a very hairy abdominal area, it may be shaved in the area of the biopsy. The attending physician checks the current coagulation values by means of a blood test. If desired, the patient may take a pain reliever and sedative before the biopsy begins. When the treatment begins, the physician determines the exact tissue location using ultrasound, endoscopic or radiological methods. Immediately after local anesthesia and disinfection of the skin area and possibly the corresponding organ parts, one or more samples are taken. Afterwards, the examination takes place within a specialized laboratory.
Risks and dangers
During a biopsy, subsequent complications occur in the rarest cases: Infections of various kinds, bleeding (that is why coagulation testing is performed in advance) within the area of the biopsy, an injury to the adjacent tissue structures as well as other nearby organs. Very rarely, cardiovascular and respiratory disorders occur due to the administration of painkillers or sedatives. As a side effect, tumor cell scattering rarely plays a role. The biopsy is a relatively minor procedure for each variant.Apart from any anesthesia required, biopsies are therefore considered to be of low stress. Studies to date have shown that tumor cells carried over by means of a biopsy can only extremely rarely grow again in other areas of the affected body. Although, for example, in breast/prostate cancer, most biopsies are taken during diagnosis, no evidence suggests that tumor cells have been carried over.
