Biopsy

A biopsy is removal of a small sample of tissue for examination under a microscope. It is the definitive test for almost all cancers — and is often needed for many non-cancerous conditions too (inflammation, infection, immune diseases). Imaging can suggest a diagnosis; a biopsy confirms it.

Common types

• FNAC (fine-needle aspiration) — a thin needle takes cells; fast, often in clinic.
• Core needle biopsy — a slightly thicker needle takes a small cylinder of tissue; provides more information.
• Punch biopsy — small circle of skin or mucosa.
• Incisional biopsy — a piece of a lesion.
• Excisional biopsy — the entire lesion removed.
• Endoscopic biopsy — during gastroscopy, colonoscopy, bronchoscopy, cystoscopy.
• Image-guided biopsy — ultrasound or CT-guided, for deep organs (liver, lung, pancreas, lymph node).
• Surgical biopsy — under anaesthesia for difficult-to-reach areas.
• Bone marrow biopsy — for blood disorders.
• Liquid biopsy — blood test looking for tumour DNA; a specialised, newer option.

What to expect

• Most biopsies are outpatient, done under local anaesthesia.
• Fasting may be required for endoscopic or image-guided procedures.
• Bleeding and clotting medicines — tell a Health Expert; some need adjusting.
• A small wound, mild soreness afterwards is normal.
• Results typically take 3-7 days; complex molecular tests can take 2-3 weeks.
• Make sure a follow-up visit is scheduled to discuss the report.

A biopsy does NOT "spread" cancer

This is a common worry, especially in India. In modern practice, biopsy causing clinically significant cancer spread is exceedingly rare and never a reason to avoid a needed diagnosis. Without a biopsy, treatment would be guesswork — and guessing is far more dangerous. Trust the process.

After the report

A good pathology report lists tumour type, grade, key markers (ER/PR/HER2 in breast; EGFR/ALK in lung; HER2/MMR in colon; PD-L1; etc). Ask for a copy. Specialist molecular testing is available at Indian reference labs when needed — discuss with the oncology team which tests are worth doing.