What is a biopsy?
A biopsy consists in taking a fragment of tissue or organ in order to analyze it. This examination is valuable for doctors because it provides a lot of information on the cells and the structure of the tissues. It will specify with certainty the diagnosis and make it possible to determine the necessary care.
The biopsy also makes it possible to carry out bacteriological analyses, to search for germs, immunological, to verify the presence of antigens thanks to antibodies, genetic or even biochemical.
What is the biopsy used for?
You should know that the biopsy is performed in many cases. It is indicated to look for an inflammatory disease, such as Crohn’s disease, or an infectious disease, lung, bone or liver.
The biopsy is also carried out in certain assessments of rare diseases, such as the puncture-biopsy of the liver to find Wilson’s disease. It is also useful for identifying a muscle disease (amyotrophic lateral sclerosis, myopathy) or detecting certain skin diseases, such as lichen.
Finally, the biopsy can determine if a tumor is benign or malignant. It provides essential information for diagnosis, determining the grade and stage of cancer, but also for management by analyzing, for example, the presence of hormone receptors in breast cancer.
How is a biopsy performed?
A biopsy is usually a short examination, less than half an hour. When it comes to superficial organs, such as the thyroid or the breast, a transcutaneous biopsy is made through the skin, under local anesthesia. It is often performed with a needle, called a trocar. The doctor can use an ultrasound to properly locate the tumor to be removed.
For deeper organs, such as the kidney, liver or in the thorax, the punctures are also done under local anesthesia. Surveillance for a few hours in a day hospital is necessary because of a higher risk of bleeding.
For surgical biopsies, performed for bone tumors or hard-to-reach organs such as the brain, hospitalization is widely recommended.
Biopsies performed under endoscopy, for example of the cervix or rectum, often require hospitalization but on an outpatient basis. Surgical biopsies are performed under general anesthesia, while endoscopic biopsies are performed under general or local anesthesia depending on the organ.
Are there risks and contraindications?
The biopsy is usually well tolerated. Pain may be felt at the time of sampling but it is reduced by anesthesia. A bruise may occur at the puncture site. If a ball, redness and / or a rise in temperature is observed, it is best to consult your doctor because it may be an abscess or a hematoma. In some cases of cancer, such as mesothelioma, there may be a risk of spreading cancer cells.
Biopsies can cause bleeding when performed on a highly vascularized organ, such as the spleen or kidneys. There is also a risk of infection and pneumothorax for the lung.
The patient’s coagulation capacity is always checked by means of a blood sample taken before the operation. A severe coagulation disorder is a contraindication because there is indeed a risk of bleeding. Another technique should then be used if possible. In patients on anticoagulant who must have a deep biopsy, the risk is circumvented by stopping the anticoagulant for a few days and/or replacing the anticoagulant with heparin. A current infection is also a contraindication.
How long does it take for biopsy results?
After being cleaned, the sample is sent to the laboratory and cut into very thin slices, to be analyzed.
It is necessary to be patient: the results are known within 1 to 3 weeks. This delay is not synonymous with bad news but it is the time necessary to carry out the study of the sample.
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