Biopsies

What Is a Biopsy?

A biopsy is when doctors take a sample of tissue or cells for testing. 

Doctors can take this sample in different ways, such as:

• surgically removing some tissue (such as a lump)
• using a needle to draw out a tissue sample
• scraping (for instance, to get a small skin sample) 

Why Are Biopsies Done?

Doctors order biopsies to:

• look for a disease or condition, such as an infection, inflammation, or cancer
• find the cause of a medical problem
• see if a condition or disease is worse or has spread
• help guide treatment

Biopsies are commonly done on:

• bone marrow: to look for anemia, blood cancers (like leukemia), and other conditions
• lymph nodes: to look for an infection or disease, like cancer
• liver: to look for liver damage or disease
• kidneys: to look for damage or diseases
• skin: to check for skin cancer, infections, or other skin problems
• esophagus: to look for signs of infection or cancer
• stomach and other parts of the digestive tract: to check for ulcers, cancer, inflammation, and infections
• muscle tissue: to look for diseases and infections that affect muscle, blood vessels, or connective tissue

What Happens Before a Biopsy?

Some biopsies require only local anesthesia. For example, doctors might give an injection to numb an area of skin before taking a sample for testing.

Others types require sedation or general anesthesia. If that's the case, a child must stop eating and drinking several hours before the biopsy to make sure the stomach is empty. Doctors give sedation and anesthesia medicines through an IV line (intravenous tube) to help the child stay asleep during the test.

Sometimes, parents can stay with their child during the biopsy for reassurance and support.

Talk to your doctor about how to prepare for a biopsy.

What Happens During a Biopsy?

In a needle biopsy (such as a bone marrow or liver biopsy), doctors clean and numb the skin, then insert a needle through the skin to get a sample. Some needle biopsies are done in a radiology department where an ultrasound or CAT scan can show the doctor exactly where to insert the needle.

Doctors do other biopsies by inserting a tiny telescope into the body, such as an endoscope into the esophagus and stomach, or a laparoscope into the belly. In an endoscopic biopsy, a small pinching instrument at the end of the endoscope snips off a small tissue sample.

Other times, they might do surgery to reach an organ to do the biopsy (called an open biopsy). A child will get general anesthesia to sleep through the surgery.

How long a biopsy takes depends on the type done. A simple skin biopsy usually takes just a few minutes, while a bone marrow biopsy can take half an hour. Open biopsies can take much longer.

What Happens After a Biopsy?

The tissue sample goes to a laboratory for testing. Depending on the type of sample, it might be treated with chemicals, cut into thinner pieces, or frozen before it's put onto glass slides. A pathologist (a doctor trained in interpreting biopsy samples) will check the slides under a microscope to help make a diagnosis.

When Are Biopsy Results Ready?

In an emergency, biopsy results can be available quickly. Otherwise, most are ready in several days.

If doctors think a child has an infection, they may start antibiotic treatment while waiting for the results.

Are There Any Risks From a Biopsy?

A biopsy is a safe procedure with few risks. Some kids might have discomfort or pain at the biopsy site for a day or two. Rarely, infection or bleeding can happen.

In very rare cases, anesthesia can cause problems (such as irregular heart rhythms, breathing problems, and allergic reactions to medicines).

How Can Parents Help?

You can help prepare your child for a biopsy by explaining that while the test might be uncomfortable, it won't take long. If sedation or anesthesia is involved, explain that your child will get a medicine to sleep through the whole procedure with no pain.

After the biopsy, make sure your child rests and follows any other instructions the doctor gives you.