Surgical biopsy

A surgical biopsy removes tissue from a lump or mass for examination under a microscope. It may also be called an open biopsy.

There are 2 types of surgical biopsies:

• An excisional biopsy removes an entire lump or abnormal area.

• An incisional biopsy removes just a piece of a lump or abnormal area.

A surgical biopsy is done to look at the cells in a lump or abnormal area. The tissue removed is sent to a pathologist (a doctor who specializes in the causes and nature of disease) who looks at the cells under a microscope. A surgical biopsy can help your doctor diagnose or rule out cancer.

Surgical biopsies can be done on abnormalities that can be seen or felt by the surgeon. They can also be done on abnormalities that cannot be felt but are seen on imaging tests such as an ultrasound, a CT scan or mammography.

A surgical biopsy may be done in a doctor’s office or hospital. Depending on the size of the lump and where it is, you may be given a local anesthetic with or without a sedative or a general anesthetic.

• The surgeon makes a small cut or incision in the skin above the abnormal area.
• If the lump can’t be felt, imaging tests are used to find the lump. A wire may be placed through the skin into the abnormal area or a metal clip put into the area, to guide the surgeon during the biopsy.
• For an excisional biopsy, the surgeon removes the entire lump or abnormal area, along with a small amount (margin) of normal tissue surrounding the lump.
• For an incisional biopsy, the surgeon removes only a small part of the lump.
• Stitches or staples are used to close the incision.

After the biopsy is done, ice and pressure may be applied to the area. A small bandage is used to cover the biopsy site.

Side effects can happen with any surgery, but not everyone has them or experiences them in the same way. Tell your healthcare team if you have side effects that you think are from the surgical biopsy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Most side effects of a surgical biopsy are temporary. These may include:

• slight bleeding or bruising
• hematomas
• tenderness
• pain
• infection
• problems with the wound healing
• scarring

A surgical biopsy of the breast may result in a change in the shape of the breast. This depends on the size and location of the lump or abnormal area, and the amount of surrounding tissue that is removed.

The pathology report shows the type of cells present, their characteristics and whether they are normal, cancerous or abnormal but not cancerous.

If the report shows that the cells are cancerous, they may need to be studied further. You may need further tests to find out the type of tumour, how fast the cells are growing and if cancer cells have spread to the surrounding normal tissue.

Find out more about cell and tissue studies.

The doctor will decide whether further tests, procedures, follow-up care or additional treatment are needed.

Preparing children before a test or procedure can lower anxiety, increase cooperation and help them develop coping skills. Preparation includes explaining to children what will happen during the test, including what they will see, feel and hear.

Preparing your child for a surgical biopsy depends on their age and experience. Find out more about helping your child cope with tests and treatments.