CHENNAI: There are many myths surrounding the medical procedure that is a biopsy. Clearing up common questions and breaking down the process is Dr Shubhra Chauhan Aranmanai, consultant head & neck oncosurgeon, Gleneagles Global Health City, Chennai.
What is a biopsy?
Biopsy is a medical test performed by removal of tissue or cells from an abnormal area in the body for diagnosis. It is primarily done to differentiate between benign (non-cancerous) and malignant (cancerous) lesions. Hence, it further helps in planning treatment. A biopsy per se does not mean that the patient has cancer.
Kinds of biopsies
There are mainly two types of biopsies — excision biopsy and incisional biopsy. In the first type, the whole abnormal tissue is removed. It is done mainly for small lesions (diseased area) or lesions which are benign clincally. While in the second type, incisional biopsy (most common procedure), only a small tissue or few cells from the lesion (ulcer, swelling, lump) are taken for testing by the pathologist. This can be done by removal of tissue by a punch, blade or large bore needle (this is called a Trucut biopsy) or small needle (called Fine Needle Aspiration Cytology).
When is a biopsy done?
A biopsy is done for any abnormal tissue, ulcer, swelling/lump that is suspicious to the clinician. It is mostly done for an ulcer or swelling that is present for more than three weeks and needs immediate attention. Similarly, it is done for nagging cough or hoarseness, any sore, change in bowel or bladder habits, unusual bleeding or discharge or a sudden change in existing mole or wart needs immediate visit to a doctor and may need biopsy eventually.
Myths on biopsies
It spreads the lesion/cancer — False. It only removes a part of the lesion and the growth of the lesion is same.
It makes the tumour more aggressive in growth — False. The tumour’s ability to spread (metastasis) in the body is not affected by biopsy. Disease worsens only when the patient takes no steps to treat it.
It causes infection to others — False. This is not possible.
It is very painful — False. It is done under local anaesthesia or sometimes short general anaesthesia.
It is the treatment — False. It is a preliminary test to plan the treatment.
The result will be ready by next day — False. It takes about 5-7 days to give a biopsy report by the pathologist. Sometimes additional tests need to be done which will need few more days.
It is a money making gimmick — False. Biopsies have helped diagnose lethal disease that mimic less sleet ones. Additional special tests will incur additional cost which will be needed in some specific cases else treatment cannot be planned.
Doing a biopsy means you have cancer — False. It is only a diagnostic test to differentiate between benign and malignant (cancer) lesion. It is also done for diagnosing infection and fungal diseases.
Delaying a biopsy once suggested by a doctor — Unlikely. This one of the most common issue when a biopsy is suggested to patient due to the fear of cancer diagnosis. One needs to understand that earlier the problem is diagnosed, smaller and easier will be the treatment. Also not all biopsies are for cancer.
Biopsy benefits
Biopsy gives early diagnosis and henceforth treatment can be done for the lesion/tumour. Only if the treating doctor knows the exact diagnosis (which is possible with biopsy), treatment can be customised. In case it is cancerous, the treatment is either surgery, radiation, chemotherapy or a combination of the above. Early treatment further stops the spread of the disease. Sometimes a lesion in one part of body can be a spread of cancer from another part of body which is not visible to us. In those cases, a biopsy can help detect even the hidden cancer from a superficial lesion.
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