What is a Surgical Biopsy?
A
surgical biopsy is a medical procedure where a surgeon removes a sample of tissue from a suspicious area to diagnose or rule out cancer. This type of biopsy is often performed when less invasive methods, such as needle biopsies, are inconclusive or not feasible.
Types of Surgical Biopsies
Excisional Biopsy
In an excisional biopsy, the surgeon removes the entire suspicious area or lump, along with some surrounding healthy tissue. This is often done when the suspicious area is small enough to be completely removed.
Incisional Biopsy
An incisional biopsy involves removing only a portion of the suspicious area or lump. This is typically done when the area is too large to be entirely removed without significant impact on function or appearance.
Sentinel Lymph Node Biopsy
This specialized biopsy is used primarily in cancers such as breast cancer and melanoma. The
sentinel lymph node is the first lymph node to which cancer cells are likely to spread. By removing and examining this node, doctors can determine whether cancer has begun to metastasize.
When is a Surgical Biopsy Necessary?
A surgical biopsy is generally recommended when:
- Imaging tests (like CT scans, MRIs, or mammograms) show a suspicious area.
- Previous biopsy results (like fine-needle aspiration or core needle biopsy) are inconclusive.
- The suspicious area is difficult to reach with needle biopsies, such as certain
internal organs.
Preparation for a Surgical Biopsy
Before undergoing a surgical biopsy, patients may need to:
- Undergo pre-operative testing, such as blood tests or imaging studies.
- Stop taking certain medications, especially blood thinners, as advised by the physician.
- Follow fasting instructions, particularly if the biopsy requires general anesthesia.The Procedure
The procedure usually involves the following steps:
1. Anesthesia: Depending on the biopsy's complexity, local or general anesthesia will be administered.
2. Incision: The surgeon makes a small incision to access the suspicious area.
3. Tissue Removal: The necessary tissue sample is removed.
4. Closure: The incision is closed with stitches or surgical staples.
5. Recovery: Patients are monitored in a recovery area until the effects of anesthesia wear off.Risks and Complications
While generally safe, surgical biopsies carry some risks, including:
- Infection at the site of the incision.
- Bleeding or hematoma (a collection of blood outside of blood vessels).
- Adverse reactions to anesthesia.
- Pain or discomfort at the biopsy site.Post-Biopsy Care
After the biopsy, patients should:
- Keep the biopsy area clean and dry.
- Follow the surgeon's instructions regarding activity restrictions and wound care.
- Watch for signs of infection, such as redness, swelling, or fever, and report any concerns to their healthcare provider.Interpreting Biopsy Results
The tissue sample is sent to a pathologist for examination under a microscope. The pathologist looks for
cancer cells and provides a detailed report that includes:
- The presence or absence of cancer.
- The type and grade of cancer, if present.
- Margins (whether cancer cells are found at the edge of the removed tissue).
Impact on Treatment Plans
The results of a surgical biopsy significantly influence the treatment plan. If cancer is detected, the biopsy results help determine the stage and aggressiveness of the cancer, guiding decisions about surgery, chemotherapy, radiation, or other treatments.Conclusion
Surgical biopsies are a critical tool in the diagnosis and management of cancer. They provide valuable information that shapes treatment strategies and helps achieve the best possible outcomes. While the procedure does carry some risks, the benefits of obtaining an accurate diagnosis often outweigh these concerns.
