A biopsy is diagnostic procedure which permits a medical doctor known as a pathologist to look at cells from your body and determine whether they are cancerous (malignant) or not cancerous (benign). 4 out of 5 biopsies do not find a malignancy.

A biopsy starts with the removal of cells or tissues from the body for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. If the biopsy shows that cancer is present, the pathologist's findings become a primary basis for helping to determine the best treatment.

There are a variety of biopsy procedures. The method that will be recommended in any particular situation depends on the size and location of the area of interest. The most common types of biopsies are: 

• Incisional biopsy, in which only a sample of tissue is removed.
• Excisional biopsy, in which an entire lump or suspicious area is removed. 
• Needle biopsy, in which a sample of tissue or fluid is removed with a needle through the skin. 
  • When a wide needle is used, the procedure is called a core biopsy. 
  • When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

Before agreeing to a biopsy: 

• Understand the type of biopsy the doctor recommends and what is involved. Ask questions such as: Does the doctor plan to use a pain killing anesthetic during the procedure?
  • If not, why not?
  • If so, ask :
    • Which anesthetic plan the doctor plans to use. 
    • What the alternatives are to the plan he or she is suggesting
    • The circumstances under which he or she may decide to administer another drug during the course of the procedure. 
• If the biopsy reveals that the sample is cancer, a common next step is to remove the cancer with surgery. 
  • Discuss whether to proceed to surgery at the same time as the biopsy, and if so, what kind of surgery. 
  • If you agree to a one step procedure of biopsy and surgery, check with your insurance company to determine whether a one step procedure is covered. It is not unusual for insurance companies to require a second opinion before covering surgery.  
• Especially if you will have a local anesthetic and will be awake during the biopsy, ask the doctor not to tell you his or her preliminary thoughts about the results. The pathologist's report is necessary to determine the results with certainty.
• Check your health insurance to see if it is covered. (Biopsies are generally covered by health insurance).
  • If it is covered, how much will you have to pay?
  • If the biopsy is not covered, what is the cost?  See Uninsured. (link to T49 ) Keep in mind that all medical bills are negotiable. To learn how to negotiate a medical bill, click here. 
• Look at the section of this document which discusses the steps to take to prepare for a biopsy.

If the biopsy shows that you have cancer, the next question is how to treat it.  For information about how to choose a treatment, see the document in "To Learn More".

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