Biopsy

A biopsy is a technique that involves removing a sample of tissue or cells from your body for more evaluation in the laboratory. You may have a biopsy to evaluate if you have cancer or another disorder. This is especially if you are showing certain signs and symptoms or if your physician has discovered a site of concern. 

Imaging tests like x-rays can help discover masses or regions of abnormality. However, they cannot tell the difference between malignant and noncancerous cells on their own. For most malignancies, a biopsy to obtain a sample of cells for detailed inspection is the only approach to make a precise diagnosis.

Types of Biopsy 

There are various types of biopsy that physicians often recommend. The type of procedure you will undergo will be based on the underlying reason for the biopsy as well as the medical history. They can thus include; 

• A punch biopsy: This is a procedure in which a special device punches a small opening in the skin to acquire a sample of the skin. 
• A needle biopsy: A specific hollow needle is used to extract tissue from an organ or from beneath the skin during a needle biopsy. This is usually guided by ultrasound, x-ray, CT scan, or MRI scan.
• An endoscopic biopsy: Medical providers often use an endoscope to extract tissue from an organ during an endoscopic biopsy. 
• An excision biopsy: This involves a surgical procedure to take out a large portion of tissue for further testing and analysis. 
• Perioperative biopsy: This form of biopsy can be performed during surgery if consent has been granted. In some cases, the sample may be examined right away to assist in guiding the procedure or later treatment. 
• Cone biopsy: This procedure entails the removal of big, cone-shaped chunks of tissue from the cervix with a knife or a laser. A general anesthetic will be administered to keep you unconscious during this procedure.
• Endocervical curettage (ECC): This procedure involves removing cells from the endocervical canal (the region between the uterus and vagina). A hand-held instrument known as a "curette" is used for this. It has a pointed tip that looks like a hook or scoop. 

Why Biopsy is performed 

In gynecology, the physician can recommend a biopsy if pelvic examination and Pap test show abnormalities. A cervical biopsy can thus help in diagnosing female reproductive conditions such as; 

Infection: A biopsy can assist in determining whether or not an infection exists in the reproductive system. It’s also vital in identifying the sort of organism that is causing it.

Inflammation: The medical practitioner can determine the underlying cause of the inflammation by studying the cells is obtained from a biopsy procedure. 

Cancer: A biopsy is the only way to determine if growth or swelling in the patient's body is cancerous or not if there is no clear explanation.

Other conditions that can be diagnosed using a biopsy include; 

• Genital warts 
• Precancerous changes within the tissue of the cervix or vagina 
• Precancerous changes of the vulva 

How to Prepare for Biopsy 

For a gynecological biopsy, you should consider scheduling it a week following your monthly period. This is to make it easy for the gynecologist to obtain a clean and clear sample. Also, you should tell the physician about any medications you're currently taking, including supplements and herbs. 

In most cases, you will be instructed to quit using medications that are likely to increase the risk of bleeding. Examples of these drugs are aspirin, naproxen, ibuprofen, and warfarin. For at least 24 hours prior to your biopsy, avoid using any douches, tampons, or medicinal vaginal creams. It's also a good idea to avoid sexual intercourse during this period.

In addition, you should stop eating or drinking anything for at least eight hours before undergoing a biopsy. This is especially if the procedure involves the use of general anesthesia.

Your doctor may advise you to take acetaminophen (Tylenol) or any pain killer before going to the medical facility on the scheduled day of the procedure. You should bring some feminine pads with you in case you have slight bleeding following the procedure.

Lastly, it's a good option to go with a family member or a friend who will drive you home if you received general anesthesia. You should not drive until the general anesthetic effects have worn off since it might make you drowsy. 

What Happens During The Biopsy?

Usually, the procedure will start with a standard pelvic examination. Your feet will be in stirrups while you lie down on an examination table. After that, your gynecologist will numb the region using a local anesthetic. You will receive a general anesthetic to make you sleep if you're having a cone biopsy.

Once the anesthesia effect begins, the physician will put a speculum (a medical device) in your vaginal canal to maintain it open throughout the process. The cervix and vagina are initially cleaned in a vinegar and water solution. Although the cleansing procedure may cause some discomfort, it’s not usually painful. Iodine swabs can also be used on the area. This is known as Schiller's test; it enables the practitioner to detect any abnormal tissues easily. 

The physician will use a scalpel, forceps, or a curette to remove the aberrant tissues from the site. If the tissue removal is done with forceps, you may feel a slight pinching sensation. 

Your doctor can compress your cervix and vagina with absorbent material once the biopsy is completed. This is to help lessen the amount of bleeding you get. However, this isn't always necessary for every biopsy. 

Recovering from Biopsy 

Punch biopsies are usually performed as outpatient treatments. This means that you can return home immediately following the procedure. Other operations may necessitate an overnight stay in the hospital. 

As you heal from your biopsy, expect some moderate discomfort, spotting, and cramping. It's possible that you will experience cramping and even bleed for up to one week. Certain activities might be limited depending on the form of biopsy you have. 

For a few weeks after a more intense colposcopy biopsy, you should avoid sexual intercourse, heavy lifting, and the use of tampons or douches. Also, following a punch biopsy and ECC operation, you may be subjected to similar restrictions, but just for a week.

Tell your doctor if you're experiencing any of the following symptoms:

• Severe pain 
• Development of a fever
• Had a lot of bleeding
• Notice a foul odor in the vaginal discharge

In certain cases, these symptoms could be an indication of vaginal or cervical infection. Hence, you should seek medical attention right away if you notice one or more symptoms. 

Results of Biopsy 

After a few days, your gynecologist will call you to discuss the outcome of the biopsy and the next plan. A negative test indicates that all is okay and that no further action is required. A positive test indicates the presence of malignant or precancerous cells, and immediate treatment may be necessary. 

If the biopsy reveals cancer signs, your gynecologist will determine the type and aggressiveness of the disease from the data. If you had a biopsy for something else other than malignancy, the lab report would help your doctor diagnose and treat the problem.

You may require an additional biopsy or another kind of biopsy if the results are negative, yet the gynecologist's suspicions for cancer or other disorders remain high. In such a situation, your physician will advise you on a suitable course of action. 

There's also the possibility that the results will be inconclusive. This indicates that the presence of cancer cells in your uterus is unknown. If this is the case, you may require a more complex medical operation known as dilation and curettage (D&C). With D&C, your physician will scrape a larger sample of tissue from your uterine lining for laboratory testing.

Risks of Biopsy 

The following are some of the potential complications that might occur during or after biopsy; 

• Bleeding
• Infection of the pelvis
• Uterine wall puncture, especially when using the biopsy equipment; this is, however, unusual.

Inform your healthcare practitioner if you are allergic or sensitive to certain medications, iodine, or even latex. Also, it’s important to tell your gynecologist if you are pregnant or suspect you might be. This is because some biopsies such as endometrial biopsy can cause miscarriage if done during pregnancy. 

Other risks of complications are also possible depending on your situation. Therefore, before the procedure, make sure to discuss any concerns you have with your physician. 

Sometimes, an endometrial biopsy can as well be hampered by a number of factors, such as;

• Infections of the vaginal or cervical canal
• Inflammation of the pelvis (pelvic inflammatory disease)
• Cervical cancer 

Conclusion 

A biopsy is a form of surgery that involves removing a small tissue sample from the area of suspicion. Gynecologists often recommend a biopsy procedure if they discover an abnormality during pap smears or pelvic exams. These anomalies can include precancerous cells or high-risk HPVs. The doctor or gynecologist may also use a biopsy to detect and treat noncancerous growths such as polyps and warts.

It’s likely that you will experience anxiety before undergoing a biopsy. Therefore, talking with your doctor to understand what the procedure involves could help you feel at ease.