Are you on the brink of a biopsy and currently scouring the internet for all the details you need? Then this article is for you! To put it in simple terms, a biopsy consists of bodily tissue or fluids being extracted from the body and being transported to and studied by pathologists, who are doctors trained to deal with the study of disease. They may not be too common when it comes to primary care visits but can play a vital role in diagnoses such as cancer, infections, and endometriosis. Your family doctor can perform one in their office if it's a simple procedure. If the procedure is complicated, a specialist doctor will take the sample. Sometimes, they will numb the area or put you to sleep so there's not much to worry about when it comes to pain! Let's read up on some details about biopsies.
Types:
Needle biopsy: A needle of varying sizes is used to take tissue or fluid samples. Some specialists take the help of Ultrasounds, CT scans or MRI's to pick up the correct tissue. The image shows a needle used for bone marrow aspiration.
Surgical biopsy: As the name indicates, this is performed by surgeons during surgery on tissues they think might be cancerous.
Cone biopsy: A scalpel is used to take a cone-shaped piece of tissue out. This is usually done on the female cervix.
Shave biopsy and Punch biopsy: These are used for skin biopsies. The skin is either shaved off or a chunk is removed in a manner similar to a hole-punch.
Endoscopic biopsy: A tube is inserted into an orifice or an incision. Structures deep inside the body can be observed and sampled.
Liquid biopsy: This is a newer type of biopsy in which a sample of blood is taken to look for cancer cells from a tumor that is circulating in the blood or for pieces of DNA from tumor cells that are in the blood.
Processing:
After the procedure is done, the tissue/fluid sample is transported to the lab where pathologists look at them without the use of a microscope. This is called a gross examination and helps guide which part of the sample should be further processed to be seen more closely.
Histology Technicians are trained personnel who then take the part of the biopsy sample that has been chosen and further prepare it so that it goes from a literal lump of tissue to the very thin slides that are placed under microscopes. A YouTube video detailing how samples are processed is linked below.
The sample is put into containers called cassettes after which it is placed in wax so that the sample becomes suspended in it and can be thinly cut into strips with the help of an instrument called a microtome. These strips are then placed on glass slides and stained with various dyes so that features of the tissue sample can be clearly identified under the microscope.
Fun Fact: Biopsy samples will sometimes be frozen instead so they can be cut more quickly and examined in cases of time-constraint.
A glance at the pathology report:
After the sample has been examined, a report will be made with a diagnosis depending on the appearance of cells and how unusual they look. The report will also mention if there are any abnormal cells at the margins of the sample. For instance, if we have a cancer biopsy and the margins are containing abnormal cells, that means the cancer was not removed as a whole and still exists inside the patient's body. Tumor markers, which are proteins made in higher amounts in cancerous cells, can also be detected and mentioned in the report. Genetic abnormalities, such as abnormal number of chromosomes, are also reported. Molecular tests may also be performed on the sample. For example, breast tissue that is positive for cancer will be checked for markers such as Estrogen and Progesterone receptors. This can help determine what type of treatment would be ideal for the patient.
In conclusion, biopsies are invaluable tools in modern medicine, offering insight into diagnosing and treating various medical conditions. As technology advances, the future of biopsies holds promise for even greater efficiency and improved patient outcomes.
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Assessed and Endorsed by the MedReport Medical Review Board