What happens with a biopsy test


The biopsy is a minimally invasive examination. The instrument can be inserted through a small incision in the skin and tissue samples can be taken.

During a biopsy, the patient is given a Tissue or fluid sample taken for microscopic examination. The procedure can thus help to diagnose diseases, to narrow them down more precisely or to control the course of operations and therapies. However, the method is usually only used for diagnosis if a specific disease has been suspected in previous examinations. Often a biopsy is done to check for abnormalities Tissue growths to check and clarify whether it is possibly cancerous tumors. But a biopsy can also be helpful when examining many other diseases. In some cases, for example when removing colon polyps, the biopsy will have one at the same time therapeutic or preventive Use.

Tissue sampling mostly on an outpatient basis with local anesthesia

A biopsy is usually done on an outpatient basis and under local anesthesia, so the person concerned usually does not need any preparation. In some cases, however, a short anesthetic is necessary, which must be discussed and planned in advance with an anesthetist. For biopsies taken in the course of a endoscopic examination such as a gastroscopy take place, the appropriate preparations must be made.

Blood tests are also done before many biopsies to determine whether a person's blood clotting is disrupted and whether their general health allows the procedure. When imaging tests like that Magnetic resonance imaging (MRI) are used to check the puncture, a contrast agent may have to be injected or swallowed beforehand.

Type of sample determines biopsy method

Different biopsy methods are used depending on the type of sample and the location from which it is to be taken. Most methods only require minor interventions. Sometimes, however, tissue material can only be removed as part of an operation. For this purpose, the affected areas are marked with a thin wire beforehand during an ultrasound examination, mammography or magnetic resonance tomography (MRT).

Different biopsy procedures

During a biopsy, tissue or fluid samples are taken using a hollow needle. Checking by ultrasound, X-ray or computed tomography can help to find the right spot.

A biopsy, which is done with a thin needle, is called Fine needle puncture. Fine needle puncture is ideal, for example, to extract fluids from the bone marrow or individual cells of the thyroid gland.

If thicker cannulas are used, the procedure is known as Punch biopsy. It is often used when cancer of the prostate (prostate biopsy) or breast cancer (breast biopsy) is suspected.

Other areas of application of the biopsy include taking tissue samples from the liver, kidneys, heart and brain. The biopsy is also used to collect ascites (ascites puncture), urine (bladder puncture), amniotic fluid (amniocentesis) or cord blood (umbilical cord puncture).

The placenta can be examined at an early stage in a pregnant woman. With this chorionic villus sampling, hereditary diseases such as trisomy 21 and other genetic malformations can be diagnosed. The chorionic villus sampling is usually done between the eleventh and thirteenth week of pregnancy.

Excisional biopsy to collect larger specimens

If only a small part of the tissue to be examined is removed, it is called an incisional biopsy. In the case of excisional biopsy, they become larger Pieces of tissue, often the entire tissue in question (e.g. tissue lump, tumor) is separated using a scalpel or a special loop. Excisional biopsy is also used, among other things, to take samples from muscles, skin, nerve tissue and blood vessels.

Colon polyps: a case for the biopsy

When taking tissue samples Body cavities are to be taken within the body, the endoscopic biopsy is used. With the help of a tube that is inserted into the intestines or the esophagus, for example, various instruments can be brought to the site of tissue removal together with the viewing device (endoscope). These can be small pliers, snares or brushes. The endoscopic biopsy is often used for colonoscopy, colon polyps can be removed immediately. Other possible areas of application are tissue removal from the esophagus, stomach or lungs.

The cell smear is also a biopsy method

There are special types of biopsy for diagnosing some diseases. A gynecological smear is part of the Cancer screening in women. In a completely painless procedure, a cell smear is taken from the cervix with a small brush and examined in the laboratory for tissue changes. In the curettagewhich, among other things, serves to rule out malignant changes to the uterine lining, the uterus is carefully scraped off under short or local anesthesia. A special form of the punch biopsy is Vacuum biopsy. Several tissue samples are sucked into the side holes of a hollow needle and separated.

Examination of the tissue samples takes four to five days

The tissue samples taken are examined using different methods. In some cases, an individual analysis is sufficient Cells off, in other cases need larger ones Pieces of tissue edited for microscopic examination. On average, the results are available four to five days after the procedure. If there are any doubts about the correctness, a tissue sample must be taken again. One problem is that, even with the aid of imaging methods, it is not always easy to actually remove the tissue sample from the desired area.

A faster evaluation method is that Rapid section examination (Abbreviation "Schnellschnitt"). It is performed during operations and can deliver results within a few minutes, enabling doctors to take appropriate action immediately in the course of an operation. Although the method is not particularly precise, it can help to avoid additional operations. The tissue samples taken in this way are usually analyzed in more detail later.

Complications rarely occur

Tissue sampling is usually a minor procedure and rarely causes complications. The possible consequences of a biopsy are short-term Bleeding or Inflammation at the site of tissue removal. With a vacuum biopsy you can scar lag behind.

The risk of tumor cells being carried over to other areas, for example by pulling out the biopsy needle, is very low, although it cannot be ruled out. Various measures, such as the use of guide needles, also help to further minimize this already low risk.

Most often, when diagnosing disease, a biopsy follows other examination methods and is only performed when a clear diagnosis cannot be made using other methods. Therefore there are no comparable alternatives to the biopsy.