Indications
In an era of personalized oncologic care, it is imperative to realize that not all tumors are the same. There are several subtypes of virtually every single cancer and furthermore, the same type of cancer may behave differently from person to person. The only way to truly understand if a patient has cancer and what type of cancer a patient is battling is to obtain a biopsy. A biopsy provides insight into the diagnosis, how aggressive or indolent the cancer is, what subtype of a particular cancer someone may have, and what treatment regimens the cancer is sensitive to.
Traditionally, biopsies were performed via open surgery. This often required a large incision, hospital admission, and a long post-operative recovery period. With the advent of new image-guided biopsy techniques, a large amount of tissue sample can now be obtained through a small pinhole in the skin. This allows for biopsies to be performed on an outpatient basis with virtually no post-procedural recovery times.
Procedural Details
Image-guided, minimally invasive biopsies are performed on an outpatient basis with same day discharge. The biopsy process begins with a behind the scenes discussion between your physician and one of our interventional radiologists. When your physician requests a biopsy, we thoroughly review all of the imaging you have had in order to come up with a plan to perform a safe, precise, and minimally invasive biopsy. On the day of the biopsy, you will arrive at the hospital in the morning. One of our physicians will greet you in our state-of-the art recovery area. This is where you will begin and end your day. We will discuss the procedure with you,including the technique and possible risks and benefits, and we will then answer any questions you may have.
Following this discussion, you will proceed to one of our imaging suites for the biopsy. Depending on the location of your tumor, we can use either x-rays, ultrasound, or CT scans to help guide placement of a needle during the biopsy procedure. Using a combination of conscious sedation and local anesthetic, we will be able to keep you very comfortable throughout the biopsy process. Then, using imaging for guidance, we will insert a small needle through a pinhole in the skin directly into the tumor, and obtain a biopsy specimen. Following the biopsy, you will go back to our recovery area where you will spend some time with us until your sedation wears off. At this point, you are typically able to go home. Your biopsy results will be forwarded to your oncologist within a few days in order to help facilitate your treatment.
Results
Following your procedure, it is common to feel some soreness in the area of the biopsy. This can typically be alleviated with over-the-counter pain medications, but often, is not severe enough to require any medications. With any biopsy procedure, there is always a small risk of bleeding or infection. In the small chance that there is significant bleeding, our interventional radiologists are on standby in order to find the source of bleeding via minimally invasive techniques and treat it.
Results typically take approximately 4-5 business days to process. During this time frame, a pathologist is able to prepare and review the biopsy specimen under a microscope in order to come up with a diagnosis. Receptor status, aggressiveness of the tumor, tumor type, and other biologic characteristics of your tumor can be evaluated with the help of our colleagues in pathology.