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Biopsies of the Colorectum

Summary

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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 are not cancerous.

A biopsy starts with the removal of cells or tissues from the body,either during surgery or during an endoscopic exam such as a colonscopy for examination by a medical doctor known as 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 pre.sent, 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 tumor or area of interest.

The most common types of biopsies are:

  • A needle biopsy. 
    • With a needle biopsy, a needle is inserted through the skin. The insertion is usually guided by a CT scan.
    • A needle biopsy is not used with respect to colorectal tumors.
    • Sometimes a needle biopsy is done to confirm the spread (metasteses) of colorectal disease to the liver or lung.
  • An endocscope during a colonoscopy.
  • During surgery 

Before agreeing to a biopsy, it is important that you do the following:

  • Understand:
    • The type of biopsy the doctor recommends 
    • The risks and benefits
  • Ask your doctor about what happens during the procedure, what you have to do to prepare for the procedure, and what to expect afterward. 
  • Check your health insurance to see if it is covered. Biopsies are generally covered by health insurance.
    • If a biopsy is covered, how much should you expect to pay?
    • If a biopsy is not covered by insurance, ask about the cost. You may be able to find a less expensive place to perform a biopsy. Also keep in mind that all medical bills are negotiable. For more information, see Uninsured and How To Negotiate A Medical Bill.
  • To learn how to prepare for a biopsy, and about what happens to tissue after a biopsy, see the other sections of this document. To learn about the resulting pathology report, click here.

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