A biopsy is a medical test involving the removal of cells or tissues for examination. A biopsy is the removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically.

What are the Indications for a Biopsy?

The indications for a biopsy include the presence of any suspicious mass or lesion on the human body. Doctors' want to know what the mass is made up of, since knowing the type of mass will help them to guide your treatment and help you determine your treatment options.

What are the Different Types of Biopsies?

-Fine Needle Aspiration
Fine needle aspiration (FNA) is a percutaneous ("through the skin") procedure that uses a fine needle and a syringe to sample fluid from a breast cyst or remove clusters of cells from a solid mass. In a fine needle aspiration, a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells.

-Needle Core Biopsy
A needle core biopsy is a procedure that removes small but solid samples of tissue using a hollow "core" needle. For palpable ("able to be felt") lesions, the physician fixes the lesion with one hand and performs a freehand needle biopsy with the other. In case of non-palpable lesions, stereotactic mammography, ultrasound, or other forms of guidance are used. In a needle core biopsy, a sample of tissue is removed with preservation of the histological architecture of the tissue's cells.

-Open Surgical Biopsy
Open Surgical Biopsy means that a large mass or lump is removed during a surgical procedure. Surgical biopsy usually requires an approximately 3 to 5 centimeter incision and is normally performed in an operating room under sterile conditions.

-Incisional Biopsy
In an incisional biopsy, a cut is made through the entire dermis down to the subcutaneous fat. Incisional biopsies can include the whole lesion (excisional, for extremely small lesions), part of a lesion, or part of the affected skin plus part of the normal skin (to show the interface between normal and abnormal skin). During an incisional biopsy, a sample of tissue is removed with preservation of the histological architecture of the tissue's cells.

-Excisional Biopsy
This is essentially the same as incisional biopsy, except the entire lesion or tumor is included. This type of biopsy is the ideal method of diagnosis of small melanomas (when performed as an excision).

What Kind of Biopsies Does a Surgeon Perform?

General surgeons are able to perform all types of biopsies. They may perform fine needle aspiration or needle core biopsy to help diagnose a suspicious mass or lesion. They use open surgical biopsy and excisional biopsy very commonly for breast lesions. Surgeons perform biopsies on a regular basis because masses and lesions are a very common surgical problem.