Biopsy and the worry about “disturbing” a tumor

What a biopsy is

A biopsy is the taking of a sample of tissue or cells for examination, which is often the only way to be certain whether cancer is present. It can be done with a needle (under ultrasound or CT guidance), during endoscopy or by surgery. The pathologist analyzes the material under the microscope and, when needed, performs further tests (immunohistochemistry, molecular tests). The type of sample depends on the organ and the diagnostic question. In some cases a larger sample or a repeat procedure is needed if the material is insufficient.

Can a biopsy spread cancer

Spread of a tumor as a result of a biopsy performed to standard is very rare. Specialists choose the technique and the route of sampling to reduce this risk. The risk is not absolutely zero for every tumor and procedure. For some masses, including suspected sarcoma, the biopsy should be planned by the relevant team before the procedure, so that the sampling route fits the possible surgical treatment. Finding spread disease after a biopsy does not prove that the procedure caused the spread: the investigation may have revealed an extent that already existed.

Why it can be more useful than waiting

When indicated, a biopsy can tell a benign condition from a malignant tumor and determine its type. In some tumors, the material also serves for the tests that help choose therapy (see diagnosis). Without this information, diagnosis may be delayed or an unsuitable treatment chosen. Imaging and tumor markers do not always replace examination of the tissue. Not every mass needs a biopsy: in some situations, for example small pulmonary nodules, diagnosis or follow-up rests on other criteria. The decision is made according to the finding and the effect the result will have on care.

Preparation and risks

Discuss pain, bleeding, infection and the specific risks for the organ. Tell the team about allergies, possible pregnancy and all medicines, especially anticoagulants and antiplatelet drugs; do not stop them yourself, since the decision depends on the risk to the heart and of thrombosis. Ask for written instructions on preparation, care after the procedure and how to receive the result. An inconclusive result may require further investigation if suspicion remains.

Care at Tirana Polyclinic: we offer oncology consultation, explanation of the indication and interpretation of the biopsy result. The procedure is recommended and organized at the relevant service according to the type of finding.