What is a biopsy? How long does a biopsy take?

What is a biopsy? How long does a biopsy take?

A biopsy is an examination consisting of removing a very small piece of tissue or organ for analysis in order to establish or confirm a medical diagnosis. This examination is frequently used in oncology and also finds applications in the diagnosis and monitoring of diseases affecting the kidneys, liver or even the lungs…

What is a biopsy?

The biopsy consists of taking a small piece of tissue or organ from an area of ​​interest, on a clinical or radiological point of call (suspicious mass, etc.). The biopsy can be performed by means of a needle, by endoscopy or conventional surgery on different types of organs. It makes it possible to reliably establish or confirm a diagnosis by different analysis methods:

Biopsy is widely used in oncology and in the study of certain autoimmune diseases. Some diseases can only be diagnosed with certainty through a biopsy.

After collection, the biopsies are quickly transported to the pathological anatomy laboratory, where they are fixed in formalin for 12 to 24 hours, then included in paraffin blocks, cut to a thickness of 3 µm then stained, before being analyzed with microscope by a pathologist. It should not be confused with cytological analysis, which consists of analyzing cells without analyzing the tissue architecture. For example, the cervico-vaginal smear used for cervical cancer screening.

Kidney biopsy 

Kidney biopsy is usually offered to make the diagnosis of kidney disease. It is the examination which makes it possible to confirm the type of renal damage, to adapt the treatment in certain cases and to make a possible prognosis on the capacity of the kidney to repair itself. Three different techniques exist:

  • Transcutaneous biopsy, the most common, which involves passing through the skin.
  • Transjugular biopsy, performed in some centers, which is reserved when transcutaneous biopsy is contraindicated (haemostasis disorder, antiplatelet/anticoagulant intake cannot be stopped, single kidney)
  • Surgical biopsy, very rare.

Precautions. ” Renal biopsy in the simplest cases (transcutaneous biopsy) requires hospitalization for 24 hours in a nephrology department ” explains Dr. Cornière and warns: ” It is necessary to stop taking any platelet aggregation inhibitor ( aspirin, NSAID or other) within 10 days before the examination and within 10 days after. In addition, your blood pressure must not be excessive and may postpone the examination if it is too high “.

Technical. Using a hollow needle (called an automatic gun), pieces of kidney, usually the left, are removed. For this, the patient lies on his stomach. This examination requires an imaging examination to guide the needle (most often ultrasound, sometimes CT). After anesthesia of the skin and the entire route to the kidney, sometimes supplemented by taking anxiolytic, light sedation or even hypnosis, the doctor introduces the needle to the lower edge of the left kidney. It then triggers a mechanism located at the end of the needle, which will allow the removal of a piece of kidney, the diameter of a spaghetti and 1 to 2 cm long. Generally, several samples are required.

After the biopsy. ” Following the examination, the patient will have to lie on his back for 24 hours and he will have to urinate in a container to allow monitoring of the urine and in particular to check the absence of blood in the urine (hematuria). ” By Afterwards, when you leave the hospital, you are asked to avoid intense physical activity for 10 days, taking anticoagulants or antiaggregants.

Read More: Breast Lift Surgery to Correct Sagging Breasts

Liver biopsy

Liver biopsies (liver biopsies) can be offered in three main settings:

  1. Diagnosis of a suspicious nodule or mass that may be cancerous
  2. The diagnosis of a chronic disease of the liver or bile ducts, following for example a disturbance in the function of the liver which may have been detected by a blood test
  3. Follow-up after a liver transplant, in order to detect a possible rejection and to adapt the treatment.

“As with the kidney, it is possible to perform biopsies transcutaneously, transjugular or surgical biopsies.” says Dr. Outh-Gauer

Breast biopsy

Breast biopsies are always intended to look for a cancerous lesion, which may have been clinically suspected by palpation, self-palpation or detected on an ultrasound and/or mammography. “ Radiologists use a score that indicates the probability that the nodule or mass is cancerous, based on the images seen on the mammogram, ” explains Dr. Outh-Gauer: this is the ACR score, scaled from 1 to 5 . In general, the biopsy is proposed in front of the lesions classified ACR4 or ACR5 which are the most worrying, sometimes ACR3.

Technical. Under local anesthesia and under radiological control, a “biopsy gun” is used to take 3  to 5 “biopsy cores” from the lesion of interest. This gesture can produce a snap that is quite impressive. “It is possible that a “clip”, i.e. a kind of staple, is left in place to allow the location of the place that has been biopsied to be identified. warns Dr. Outh-Gauer. Some hospitals offer breast cancer screening day hospitals, where biopsies are taken in the morning and the report is available at the end of the day or 24-48 hours. An alternative to biopsy is the fine needle aspiration, which allows cytological analysis but where the

Lung biopsy

Lung biopsies are mainly requested for the search for cancerous lesions, but also, in rarer cases, for the search for inflammatory and infectious diseases such as, for example, tuberculosis. The biopsy approach is very dependent on the location of the lesions: peripheral close to the chest wall or central, close to the bronchi, diffuse or localized to a single sector…

Technical. ” Biopsies can be performed transcutaneously, in the operating room or transbronchial (which involves inserting a tube through the nose, trachea and into the bronchi “, explains Dr. Outh-Gauer. The anesthesia modalities depend on the biopsy approach chosen.The biopsy can also be guided by scanner or ultrasound.

Brain biopsy

The indication for brain biopsy is overwhelmingly the diagnosis of tumor. It is very rarely performed in other settings (inflammatory diseases, infectious diseases, etc.). It can be performed using a stereotactic frame, or “in the open” during a “conventional” surgical procedure. ” In any case, it is a neurosurgeon who performs it.” says Dr. Forest.

Technical. For the stereotactic biopsy, a metal frame is fixed in the bone of the skull, this frame makes it possible to locate the biopsy zone as well as possible thanks to imaging (scanner). This scanner is made with this frame to clearly identify the sampling area. ” This framework can be fixed without general anesthesia ” explains Dr. Forest: ” only the skin, the bone and the meninge are sensory innervated. The brain itself does not have a painful sensory nerve, the sample itself is painless “. The risk is mainly that of bleeding within the biopsy site.

The surgeon can request an extemporaneous examination (which gives a result in 20 min) to ensure the representativeness of the sample, i.e. to check that he is taking samples in the area of ​​interest to be biopsied and that the anatomo – pathologist has enough material to carry out all the necessary complementary examinations.

Read Also: How Much Does A Colonoscopy Cost?

Trophoblast biopsy (pregnancy test)

Trophoblast is the name given to the placenta during the first trimester of pregnancy. This biopsy consists of taking cells belonging to the fetus from above to analyze its chromosomes in detail. To do this, the cells once collected are brought to the laboratory which will culture them in order to have enough to carry out the necessary analyses. This sample is taken when there is a suspicion of genetic abnormalities for the current pregnancy: trisomy 21, cystic fibrosis or other

Technical. “The gesture is very similar to amniocentesis but has the advantage of being able to be done earlier in pregnancy, between 11 and 14 weeks of amenorrhea, whereas amniocentesis is usually done from 16 weeks of gestation. amenorrhea” explains Dr. Maatouk. These two gestures have the same risk of miscarriage, currently estimated at 1/1000.

According to the hospitals, the gesture is carried out either in an operating theater or in a dedicated room, but always in compliance with the rules of sterility in order to avoid infections. Depending on the operator’s habits, local anesthesia can be performed, only on the skin. “The gesture is slightly painful but not to the point of requiring general anesthesia, ” reassures Dr. Maatouk: “patients often compare it to the pain of a blood test.

The sample is taken under continuous ultrasound control in order to permanently see the needle and not “prick” the fetus. Once the cells are collected, they are placed in a culture medium and brought to the laboratory.

After the exam. It is advisable to remain calm for a few days after the collection but while living normally and to consult in the event of loss of blood or liquid. The result is generally available after an average of three weeks (the cell culture time is an incompressible time).

Disadvantages. “ The trophoblast biopsy has two drawbacks, ” warns Dr. Maatouk. The trophoblast is not always accessible, and it sometimes happens, even if the collection went well, that the cells removed do not grow in culture. then repeat the biopsy, usually by doing an amniocentesis”.

Biopsy of the cervix

Cervical biopsy is performed as part of cervical cancer screening when an abnormality has been detected on the Pap smear. It is carried out during an examination called colposcopy, whereas for a classic gynecological examination, the cervix is ​​visualized thanks to the introduction of a speculum.

Technical. “ The cervix is ​​smeared with a reagent which makes it possible to better visualize the abnormal zones ” explains Dr. Outh-Gauer “ These which can then be looked at with a magnifying glass and possibly be biopsied. ” Biopsies make it possible to visualize any precancerous lesions (classified from the least serious to the most serious CIN 1 to 3), cancerous lesions and to look for the presence of human papillomavirus (HPV).

Endometrial biopsy

Endometrial biopsy is requested in two settings:

  1. the search for cancerous lesions on a clinical call point such as abnormal bleeding (meno- or metrorrhagia),
  2. during an infertility assessment.

It is performed endoscopically, by introducing a cannula into the uterus via the vagina and the cervix.

Bone biopsy

Bone biopsy is requested in 3 contexts:

  • The search for cancerous lesions of organs that have metastasized to the bones,
  • Search for chronic infections such as tuberculosis,
  • The search for blood diseases (leukemia, lymphoma, abnormal production of red blood cells and white blood cells, etc.).

For the diagnosis of metastasis or infection, the biopsy is carried out at the place where an abnormal image is visualized in the scanner, in MRI… For the diseases of the blood, one takes bone marrow which is the seat of the manufacture of red blood cells, white blood cells and platelets. Two sites are possible: the posterior or anterior iliac spine, at the level of the pelvis, or the sternum. These procedures are usually done under local anesthesia. ” This biopsy can be supplemented by a myelogram, which is a bone marrow sample with cytological analysis ” specifies Dr. Outh-Gauer.

Stomach biopsy

The main framework is that of the search for lesions of gastritis, in front of symptoms such as heartburn, ulcers, reflux. ” We are looking for the bacterium responsible: Helicobacter pylori, which can be treated” by a course of antibiotics “explains Dr. Outh-Gauer. More rarely, we can look for cancerous lesions in the same way.

Technical. This biopsy is performed during an upper endoscopy, with the introduction of a tube with a camera in the mouth, esophagus, stomach, duodenum, two or three series of biopsies in the different areas of the stomach: the fundus, the antrum, more or less in the duodenum. The camera allows biopsies to be targeted to the most suspicious areas. The gesture is most often performed under general anesthesia, on an outpatient basis.

How long does a biopsy take?

Biopsy procedure is usually variable and its duration is about 15 to 30 minutes or 60 minutes which also depends upon the body part to be biopsied. The biopsy sample is saved in a special kind of preservative and sent to the pathology laboratory for further processing.

How long does it take to get biopsy results

The time for results is between a few hours for the most urgent cases and one to three weeks.

Read: What is a BBL?

Leave a Comment

Your email address will not be published. Required fields are marked *