Surgical Biopsy

(Incisional biopsy, excisional biopsy)

Procedure overview

If your healthcare provider suspects that you have cancer, the way to find out for sure often starts with an imaging test, such as magnetic resonance imaging (MRI), positron emission tomography (PET), or a computed tomography (CT) scan. To find out more, the healthcare provider may want to take a sample of the tissue to look at it under a microscope. This procedure is known as a biopsy. Biopsies can be done in many ways. They are the only way to confirm the diagnosis of cancer.

Reasons for the procedure

Your healthcare team may do a biopsy to rule out or confirm cancer. The procedure offers healthcare providers a chance to get a closer look at the affected tissue to find out exactly what they are dealing with.

Biopsies may be done using:

  • A needle to take the sample

  • An endoscope, which is a thin, flexible tube with a light on it that lets the healthcare provider look at the tissue and take a sample

  • A vacuum device to take the tissue from the body and gather it in a probe

In some cases, though, your healthcare provider may not be able to get a good sample from these less invasive procedures. Or the results might not be clear. Your healthcare provider may then decide to do a surgical biopsy. This is more like a regular surgery. The healthcare provider needs to make an incision or cut to take out a sample.

The healthcare provider may do one of two types of surgical biopsies: incisional or excisional. With an incisional biopsy, the goal is to take only a small sample of tissue, just enough to make the diagnosis. With an excisional biopsy, the goal is to remove all of the suspicious tissue or tumor. This makes it the most invasive form of biopsy. But it also provides the best sample to test. It can also bring peace of mind with the knowledge that the cancer might have been taken out of your body.

Risks of the procedure

Like any surgery, a biopsy has some risks tied to it:

  • Chance of infection

  • Pain at the site of the biopsy

  • Excessive bleeding during or after the biopsy

  • Affected body part may be cosmetically changed

There may be other risks, depending on your health problem. Be sure to discuss any concerns with your healthcare provider before the procedure.

Before the procedure

A surgical biopsy is generally done on an outpatient basis. Preparation depends on the type of biopsy you will have. Check with your healthcare provider about the medicines you take and whether you can eat or drink before the procedure. 

Based on your condition and type of biopsy, your healthcare provider may request other specific preparations. 

During the procedure

Typically, a surgical biopsy will be done in a hospital and follow these steps:

  • You will wear a hospital gown and lie on an operating table.

  • You will be given a local anesthetic at the site of the biopsy. This is a drug used to make the area numb.

  • You may also be given medicine to make you drowsy.

  • The incision, or cut, will be made.

  • The suspicious tissue will be removed, as well as a border of healthy tissue.

  • Once the tissue sample or tumor is removed, the healthcare provider will close the cut. A bandage will be applied.

  • Depending on what medicine you were given before the test, you may need to be watched for a short period of time before you are allowed to go home. If you were given any type of sedation, you will need to have someone drive you home. 

After the procedure

After the biopsy, your healthcare provider will send the tissue to a lab for review. In a few days to a week, the lab will send a written report to the healthcare provider. The next course of action will depend on the lab findings.

You may feel some soreness or tenderness at the surgical site as it heals. You may need medicine to control this pain. You may be told not to let the incision get wet for a few days and be given other care instructions. Avoid any heavy lifting and generally take it easy until you're feeling back to normal. Let your healthcare provider know if you have any signs of infection, severe pain, fever, or bleeding.