Staging is the process of determining how much cancer is within the body (tumor size) and if it has spread. To learn the stage of the disease, doctors may order x-rays, lab tests, and other tests or procedures. Learn about the TNM Staging system and other ways that stage is described.
Colon cancer staging 1 of 5
Image by TheVisualMD
What Is Cancer Staging?
Colorectal Cancer Confined to Colon Wall Stage 0
Colorectal Cancer Spread Past Mucosa Stage 1
Colorectal Cancer Spread Into Colon Stage 2
Colorectal Cancer Spread to Lymph Nodes Stage 3
Colorectal Cancer Spread to Body Stage 4
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Colorectal Cancer Spread to Body
Interactive by TheVisualMD
Colorectal Cancer Confined to Colon Wall Stage 0
Colorectal Cancer Spread Past Mucosa Stage 1
Colorectal Cancer Spread Into Colon Stage 2
Colorectal Cancer Spread to Lymph Nodes Stage 3
Colorectal Cancer Spread to Body Stage 4
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Colorectal Cancer Spread to Body
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage III: Cancer has spread to nearby tissues or organs and lymph nodes, but not to distant parts of the body.
Interactive by TheVisualMD
What Is Cancer Staging?
Stage refers to the extent of your cancer, such as how large the tumor is, and if it has spread. Knowing the stage of your cancer helps your doctor:
Understand how serious your cancer is and your chances of survival
Plan the best treatment for you
Identify clinical trials that may be treatment options for you
A cancer is always referred to by the stage it was given at diagnosis, even if it gets worse or spreads. New information about how a cancer has changed over time gets added on to the original stage. So, the stage doesn't change, even though the cancer might.
Source: National Cancer Institute (NCI)
Additional Materials (17)
The Staging and Grading of Cancer
Video by Learn Oncology/YouTube
Neoplasia: Grading and Staging
Video by Pathweb Teacher/YouTube
Cervical Cancer Progression and Staging
Video by Covenant Health/YouTube
What Is the Difference Between Staging and Grading in Breast Cancer?
Video by Cleveland Clinic/YouTube
Lung Cancer: Staging Presentation
Video by Demystifying Medicine/YouTube
Staging cancers: TNM and I-IV systems
Video by Oncology for Medical Students/YouTube
Colon cancer staging
Colon cancer staging
Colon cancer staging
Colon cancer staging
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Stages of Colorectal Cancer
Interactive by TheVisualMD
T1 - the tumor is 2 cm across or less.
T2 - the tumor is more than 2 cm but no more than 5 cm across.
T3 - the tumor is bigger than 5 cm across.
Stage 3B breast cancer - Diagram 1 of 2
3D medical animation still showing metastatic or stage 4 Breast Cancer
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TNM Staging for Breast Cancer
The breast cancer TNM staging system is the most common way that doctors stage breast cancer. TNM stands for Tumor, Node, Metastasis. Your scans and tests give some information about the stage of your cancer. But your doctor might not be able to tell you the exact stage until you have surgery.
Interactive by Cancer Research UK
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
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TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Uterine Cancer - Stages 1A and 1B cancer
Uterine Cancer - Stage 2 cancer
Uterine Cancer - Stages 3A to 3C cancer
Uterine Cancer - Stages 4A and 4B cancer
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Stages of Uterine Cancer
Interactive slider showing stages 1A, 1B, 2, 3A, 3B, 3C, 4A, and 4B uterine cancer
Interactive by Cancer Research UK / Wikimedia Commons
Diagram showing stage M1 thyroid cancer.
Thyroid Cancer - Stage N1a
Thyroid Cancer - Stage N1b
Thyroid Cancer - Stage T1a
Diagram showing stage T1b thyroid cancer.
Diagram showing stage T2 thyroid cancer.
Diagram showing stage T3 thyroid cancer.
Diagram showing stage T4a thyroid cancer.
Diagram showing stage T4b thyroid cancer.
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Thyroid Cancer - Staging
Interactive by Cancer Research UK / Wikimedia Commons
Stage 1A and 1B lung cancer
Stage 2A lung cancer
Option for stage 2Bb lung cancer
Stage 3A lung cancer - Diagram 1 of 3
Stage 3A lung cancer - Diagram 2 of 3
Stage 3A lung cancer - Diagram 3 of 3
Stage 3B lung cancer - Diagram 1 of 2
Diagram 2 of 2 showing stage 3B lung cancer
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Stages - Lung Cancer
Interactive by Cancer Research UK / Wikimedia Commons
Stage 1: Cancer is confined to a small area of the prostate.
Stage 2: Cancer is confined to the prostate but has spread within it, patient had a high Gleason score, had a high PSA level, or can be felt.
Stage 3: Cancer has spread outside the prostate and may have spread to the seminal vesicles, but has not spread anywhere else.
Stage 4: Cancer has spread to nearby tissues (other than the seminal vesicles), or to the lymph nodes, or to distant sites in the body.
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Prostate Cancer Summary Staging
Cancer staging helps in estimating the patient's prognosis and in deciding on treatment. If tests show the cancer is likely to have spread, imaging and other tests are done to see the extent of the cancer and to assign it a stage.
Interactive by TheVisualMD
Vaginal Cancer - Stage 1
Vaginal Cancer - Stage 2
Vaginal Cancer - Stage 3
Vaginal Cancer - Stage 4A
Vaginal Cancer - Stage 4B
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Stages of Vaginal Cancer
Diagram showing stage 1, 2, 3, 4A, and 4B vaginal cancer
Interactive by Cancer Research UK / Wikimedia Commons
Interactive by Cancer Research UK / Wikimedia Commons
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Cancer Staging
Foods demonstrating the average size of breast tumors when discovered by touch vs found through imaging. Different Foods Showing Sizes of Tumors Found by Touch vs Imaging : Left to right: 1) Breast calcifications are too small to be felt but can be seen as white spots on a mammogram. 2) Average size of lump detected with routine mammogram: .43 inches/1.1 cm (blueberry). 3) Average size of lump detected with first mammogram: .59 inches/1.5 cm (hazelnut). 4) Average size of lump found by regular breast self-exam: .83 inches/2.1 cm (grape). 5) Average size of lump found accidentally: 1.42 inches/3.6 cm (strawberry).
Image by TheVisualMD
5:40
The Staging and Grading of Cancer
Learn Oncology/YouTube
8:25
Neoplasia: Grading and Staging
Pathweb Teacher/YouTube
2:34
Cervical Cancer Progression and Staging
Covenant Health/YouTube
2:30
What Is the Difference Between Staging and Grading in Breast Cancer?
Cleveland Clinic/YouTube
5:32
Lung Cancer: Staging Presentation
Demystifying Medicine/YouTube
8:10
Staging cancers: TNM and I-IV systems
Oncology for Medical Students/YouTube
Stages of Colorectal Cancer
TheVisualMD
TNM Staging for Breast Cancer
Cancer Research UK
TNM Staging for Pancreatic Cancer
Cancer Research UK
Stages of Uterine Cancer
Cancer Research UK / Wikimedia Commons
Thyroid Cancer - Staging
Cancer Research UK / Wikimedia Commons
Stages - Lung Cancer
Cancer Research UK / Wikimedia Commons
Prostate Cancer Summary Staging
TheVisualMD
Stages of Vaginal Cancer
Cancer Research UK / Wikimedia Commons
Stages of Cervical Cancer
Cancer Research UK / Wikimedia Commons
Staging Cancer
TheVisualMD
Cancer Staging
TheVisualMD
How Stage Is Determined
X-ray imaging tests
Image by Centers for Disease Control and Prevention (CDC)
X-ray imaging tests
An x-ray is an image created on photographic film or electronically on a digital system to diagnose illnesses and injuries. During this type of medical imaging procedure, an x-ray machine is used to take pictures of the inside of the body. The x-rays pass through various parts of the body to produce images of tissues, organs, and bones.
Image by Centers for Disease Control and Prevention (CDC)
How Stage Is Determined
To learn the stage of your disease, your doctor may order x-rays, lab tests, and other tests or procedures.
Source: National Cancer Institute (NCI)
Bone Marrow Tests
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
Bone Marrow Tests
Also called: Bone Marrow Examination, Bone Marrow Aspiration and Biopsy
Bone marrow tests are used to diagnose and monitor bone marrow diseases, blood disorders, and certain types of cancer. There are two types of bone marrow tests: bone marrow aspiration and bone marrow biopsy, tests usually performed at the same time.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative bone marrow biopsy results indicates that the bone marrow didn’t have any significant findings with all of the testing that was done. This may mean that certain diseases were not found. It may also mean that the bone marrow is functioning normally.
Related conditions
Bone marrow is a soft, spongy tissue found in the center of most bones. Bone marrow makes different types of blood cells, including:
Red blood cells (also called erythrocytes), which carry oxygen from your lungs to every cell in your body
White blood cells (also called leukocytes), which help you fight infections
Platelets, which help with blood clotting
Bone marrow tests check to see if your bone marrow is working correctly and making normal amounts of blood cells. The tests can help diagnose and monitor bone marrow disorders, blood disorders, and certain types of cancer.
There are two types of procedures used to collect bone marrow samples for testing:
Bone marrow aspiration removes a small amount of bone marrow fluid and cells
Bone marrow biopsy removes a small piece of bone and bone marrow
Bone marrow aspiration and bone marrow biopsy are usually done at the same time.
Other names: bone marrow examination
Bone marrow tests are used to:
Find out the cause of problems with red blood cells, white blood cells, or platelets
Diagnose and monitor blood disorders, such as:
Anemia (when the cause is unknown)
Polycythemia vera
Thrombocytopenia
Diagnose bone marrow disorders
Diagnose and monitor treatment for certain types of cancers, including leukemia, multiple myeloma, and lymphoma
Diagnose the cause of an unexplained fever, which could be from an infection in the bone marrow
Your health care provider may order a bone marrow aspiration and a bone marrow biopsy if other blood tests show your levels of red blood cells, white blood cells, or platelets are not normal.
Too many or too few blood cells may mean you have a medical condition, such as cancer that starts in your blood or bone marrow. If you are being treated for another type of cancer, these tests can find out if the cancer has spread to your bone marrow.
Bone marrow tests may also be used to see how well cancer treatment is working.
Bone marrow aspiration and bone marrow biopsy procedures are usually done at the same time. A health care provider will collect the marrow samples for testing. Usually, the samples can be collected in about ten minutes.
Before the procedure, you may be asked to put on a hospital gown. Your blood pressure, heart rate, and temperature will be checked.
You may choose to have a mild sedative, which is medicine to help you relax. You may also have the choice to use stronger medicine that will make you sleep. Your provider can help you decide which option is best for you.
During the procedure:
You'll lie down on your side or your stomach, depending on which bone will be used to get the samples. Most bone marrow samples are taken from the back of the hip bone, called the iliac crest. But other bones may be used.
An area of skin over the bone will be cleaned with an antiseptic.
You will get an injection (shot) of medicine to numb the skin and the bone underneath. It may sting.
When the area is numb, the provider will make a very small incision (cut) in your skin and insert a hollow needle. You will need to lie very still during the procedure:
The bone marrow aspiration is usually done first. The provider will push the needle into the bone and use a syringe attached to the needle to pull out bone marrow fluid and cells. You may feel a brief, sharp pain. The aspiration takes only a few minutes.
The bone marrow biopsy uses a special hollow biopsy needle inserted through the same skin opening. The provider will twist the needle into the bone to take out a small piece, or core, of bone marrow tissue. You may feel some pressure or brief pain while the sample is being taken.
After the test, the health care provider will cover your skin with a bandage.
If you didn't use medicine to relax or sleep, you'll usually need to stay lying down for about 15 minutes to make sure that the bleeding has stopped. Afterwards, you can do your usual activities as soon as you are able. If you used medicine to relax or sleep, you'll need to stay longer before you can go home. You may also need to rest the next day.
Your provider will tell you whether you need to fast (not eat or drink) for a few hours before the procedure.
Plan to have someone take you home after the test, because you may be drowsy if you are given medicine to help you relax or sleep during the procedure.
You'll receive instructions for how to prepare, but be sure to ask your provider any questions you have about the procedure.
After a bone marrow aspiration and bone marrow biopsy you may feel stiff or sore where the sample was taken. This usually goes away in a few days.
Your provider may recommend or prescribe a pain reliever to help. Don't take any pain medicine your provider hasn't approved. Certain pain relievers, such as aspirin, could increase your risk of bleeding.
Serious symptoms are very rare, but may include:
Increased pain or discomfort where the sample was taken
Redness, swelling, bleeding, or other fluids leaking from at the site
Fever
If you have any of these symptoms, call your provider.
It may take several days or even weeks to get your bone marrow test results. Your provider may have ordered many different types of tests on your marrow sample, so the results often include a lot of complex information. Your provider can explain what your results mean.
In certain cases, if your test results are not normal, you may need to have more tests to confirm a diagnosis or to decide which treatment would be best.
If you have cancer that affects your bones and marrow, your test results may provide information about your cancer stage, which is how much cancer you have in your body and how fast it may be growing.
If you are already being treated for cancer, your test results may show:
How well your treatment is working
Whether your treatment is affecting your bone marrow
Bone Marrow Tests: MedlinePlus Medical Test [accessed on Feb 16, 2024]
Additional Materials (22)
Bone marrow: location and labeled histology (preview) | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
What to expect when you have a Bone Marrow Test | Cancer Research UK
Video by Cancer Research UK/YouTube
Having a bone marrow test
Video by Design Science/YouTube
Bone Marrow Transplant - Mayo Clinic
Video by Mayo Clinic/YouTube
Bone Marrow Diseases - What You Need To Know
Video by Rehealthify/YouTube
What Does Bone Marrow Actually Do?
Video by Seeker/YouTube
Aplastic Anemia-Bone Marrow
Image by doctorssupport.org
Bone Marrow Procedure Site
A 3D medical animation still showing preferred Sites for Bone Marrow Aspiration. The preferred sites for the procedure.
Image by Scientific Animations, Inc.
Image of a bone marrow harvest
Georgetown University Hospital, Washington, D.C. -- Surgeon Dr. Hans Janovich performs a bone marrow harvest operation on Aviation Electronics Technician 1st Class Michael Griffioen. The procedure consists of inserting a large-gauge syringe into an area of the hip and extracting the bone marrow. It is transfused into the recipient, and helps to recreate and replenish T-cells and the white and red blood cells killed while undergoing chemotherapy. Griffioen is assigned to the Pre-commissioning Unit Ronald Reagan (CVN 76) and was matched with an anonymous cancer patient through the Department of Defense Marrow Donor Program.
Image by Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
Healthy kidneys produce a hormone called erythropoietin, or EPO, which stimulates the bone marrow to make red blood cells needed to carry oxygen throughout the body. Diseased kidneys don’t make enough EPO, and bone marrow then makes fewer red blood cells.
Image by NIDDK Image Library
Red Blood Cells, Bone Marrow
A skeleton may have a dry and lifeless Halloween image, but bone is actually dynamic, living tissue. Bone is not uniformly solid; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). As the source of blood cells, the bone marrow is critical to health. Disease or damage to bone marrow can result in either too many or too few blood cells.
Image by TheVisualMD
Erythropoiesis in Bone Marrow
Bone is dynamic, living tissue; within its interior is a network of cavities that house blood vessels and marrow. Bone marrow, particularly in larger bones, is where stem cells give rise to red blood cells (erythrocytes) as well as white blood cells (leukocytes) and blood clotting agents (platelets). Specialized cells in the kidney, which are sensitive to low oxygen levels, produce a hormone called erythropoietin (EPO), which in turn promotes the production of red blood cells. The boost in red blood cell production (erythropoiesis) in turn increases the oxygen-carrying capacity of the blood.
Image by TheVisualMD
Bone Marrow
Red bone marrow fills the head of the femur, and a spot of yellow bone marrow is visible in the center. The white reference bar is 1 cm.
Image by CNX Openstax
This browser does not support the video element.
Femur Bone Marrow Revealing Lacunae and Trabeculae
Camera descending into bone marrow dataset. Within the bone matrix that is shown one can see the spaces in the matrix which are called lacunae and the trabeculae which is a the mesh work of bone tissue
Video by TheVisualMD
Hematopoietic System of Bone Marrow
Hemopoiesis is the proliferation and differentiation of the formed elements of blood.
Image by CNX Openstax
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
White blood cells (WBCs) and red blood cells (RBCs), as well as the cell fragments called platelets, are constantly being produced by bone marrow. Disease, cancer and genetic disorders of bone marrow can, in turn, affect the production of blood cells.
Image by TheVisualMD
Bone marrow core biopsy microscopy panorama
Section of bone marrow core biopsy as seen under the microscope.
Image by Gabriel Caponetti
Bone Marrow Biopsy
Bone Marrow Biopsy
Image by John Doe
Bone Marrow Biopsy
Diagram showing a bone marrow biopsy.
Image by Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
Disease or damage to the bone marrow, caused by infection, cancer, radiation treatment, or chemotherapy can lower white blood cell count by impairing the marrow's ability to produce new white blood cells.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Blood Cells
This is a scanning electron microscope image from normal circulating human blood. One can see red blood cells, several white blood cells including lymphocytes, amonocyte, a neutrophil, and many small disc-shaped platelets. Red cells are nonnucleated and contain hemoglobin, an important protein that contains iron and allows the cell to carry oxygen to other parts of the body. They also carry carbon dioxide away from peripheral tissue to the lungs where it can be exhaled. The infection-fighting white blood cells are classified in two main groups: granular and agranular. All blood cells are formed in the bone marrow. There are two types of agranulocytes: lymphocytes, which fight disease by producing antibodies and thus destroying foreign material, and monocytes. Platelets are tiny cells formed in bone marrow and are necessary for blood clotting.
Image by Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
3:24
Bone marrow: location and labeled histology (preview) | Kenhub
Kenhub - Learn Human Anatomy/YouTube
2:12
What to expect when you have a Bone Marrow Test | Cancer Research UK
Cancer Research UK/YouTube
5:56
Having a bone marrow test
Design Science/YouTube
2:20
Bone Marrow Transplant - Mayo Clinic
Mayo Clinic/YouTube
1:38
Bone Marrow Diseases - What You Need To Know
Rehealthify/YouTube
4:03
What Does Bone Marrow Actually Do?
Seeker/YouTube
Aplastic Anemia-Bone Marrow
doctorssupport.org
Bone Marrow Procedure Site
Scientific Animations, Inc.
Image of a bone marrow harvest
Photographers Mate 2nd Class Chad McNeeley
Diagram showing the process of red blood cell production in the body with healthy and diseased kidneys. On the top half of the diagram, on the left side, a kidney labeled “Healthy kidney” starts the process by producing EPO. Six drops represent “Normal EPO.” An arrow beneath the EPO drops points from the kidney to a cross-section of a bone. Several cells labeled “Normal red blood cells” emerge from the bone marrow. Above the red blood cells, the label “Normal oxygen,” with three arrows pointing
NIDDK Image Library
Red Blood Cells, Bone Marrow
TheVisualMD
Erythropoiesis in Bone Marrow
TheVisualMD
Bone Marrow
CNX Openstax
0:06
Femur Bone Marrow Revealing Lacunae and Trabeculae
TheVisualMD
Hematopoietic System of Bone Marrow
CNX Openstax
Bone Marrow Biopsy
Blausen Medical Communications, Inc.
White Blood Cell Count: Bone
TheVisualMD
Bone marrow core biopsy microscopy panorama
Gabriel Caponetti
Bone Marrow Biopsy
John Doe
Bone Marrow Biopsy
Cancer Research UK / Wikimedia Commons
White Blood Cell Count: Bone Marrow
TheVisualMD
Sensitive content
This media may include sensitive content
Blood Cells
Bruce Wetzel (photographer). Harry Schaefer (photographer), National Cancer Institute
Brain Biopsy
Brain Biopsy
Also called: Biopsy - Brain
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
Brain Biopsy
Also called: Biopsy - Brain
A brain biopsy is typically performed after an imaging test confirmed the presence of a brain tumor or mass. The test is used to confirm or rule out brain cancer.
If imaging tests show there may be a brain tumor, a biopsy is usually done. One of the following types of biopsies may be used:
Stereotactic biopsy: When imaging tests show there may be a tumor deep in the brain in a hard to reach place, a stereotactic brain biopsy may be done. This kind of biopsy uses a computer and a 3-dimensional (3-D) scanning device to find the tumor and guide the needle used to remove the tissue. A small incision is made in the scalp and a small hole is drilled through the skull. A biopsy needle is inserted through the hole to remove cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Open biopsy: When imaging tests show that there may be a tumor that can be removed by surgery, an open biopsy may be done. A part of the skull is removed in an operation called a craniotomy. A sample of brain tissue is removed and viewed under a microscope by a pathologist. If cancer cells are found, some or all of the tumor may be removed during the same surgery. Tests are done before surgery to find the areas around the tumor that are important for normal brain function. There are also ways to test brain function during surgery. The doctor will use the results of these tests to remove as much of the tumor as possible with the least damage to normal tissue in the brain.
Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.Craniotomy: An opening is made in the skull and a piece of the skull is removed to show part of the brain.
The pathologist checks the biopsy sample to find out the type and grade of brain tumor. The grade of the tumor is based on how the tumor cells look under a microscope and how quickly the tumor is likely to grow and spread.
The following tests may be done on the tumor tissue that is removed:
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of brain tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
For some tumors, a biopsy or surgery cannot be done safely because of where the tumor formed in the brain or spinal cord. These tumors are diagnosed and treated based on the results of imaging tests and other procedures.
Sometimes the results of imaging tests and other procedures show that the tumor is very likely to be benign and a biopsy is not done.
https://www.cancer.gov/types/brain/patient/adult-brain-treatment-pdq [accessed on Sep 19, 2019]
https://www.cancer.gov/rare-brain-spine-tumor/blog/2019/understanding-brain-tumors [accessed on Sep 19, 2019]
https://www.healthline.com/health/brain-biopsy [accessed on Sep 19, 2019]
https://www.dana-farber.org/brain-tumors/diagnosis/ [accessed on Sep 19, 2019]
https://www.mercy.com/health-care-services/cancer-care-oncology/specialties/brain-tumor-treatment/treatments/brain-biopsy [accessed on Sep 19, 2019]
Additional Materials (7)
Brain biopsy under stereotaxy.
Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system. The frame around the patient's head ensures a correct axis towards the target (max. error : ~1 mm)
Image by Dake~commonswiki
What to know about a brain tumor diagnosis
Video by Mayo Clinic/YouTube
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
Video by MassGeneralHospital/YouTube
Stereotactic brain biopsy
Video by Institute for Cancer Genetics and Informatics/YouTube
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Video by Mayo Clinic/YouTube
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Video by Cancer Research UK/YouTube
Distinguishing Brain Tumors
Video by Lee Health/YouTube
Brain biopsy under stereotaxy.
Dake~commonswiki
1:43
What to know about a brain tumor diagnosis
Mayo Clinic/YouTube
3:24
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
MassGeneralHospital/YouTube
2:20
Stereotactic brain biopsy
Institute for Cancer Genetics and Informatics/YouTube
7:02
Brain Tumor Diagnosis and Treatment - Mayo Clinic
Mayo Clinic/YouTube
1:08
Brain Tumour facts: 10 things you should know about brain tumours | Cancer Research UK
Cancer Research UK/YouTube
1:49
Distinguishing Brain Tumors
Lee Health/YouTube
Breast Biopsy
Breast Biopsy
Also called: Biopsy of the Breast
A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.
Breast Biopsy
Also called: Biopsy of the Breast
A breast biopsy is a test that can confirm or rule out breast cancer. It is used if other breast tests or a physical exam show you might have breast cancer. There are three main types of breast biopsy procedures: fine-needle aspiration, core needle biopsy, and surgical biopsy.
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A normal biopsy means that no cancer or abnormal cells were found.
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A breast biopsy is a procedure that removes a sample of breast tissue so that it can be checked for signs of disease. A doctor called a pathologist looks at the tissue under a microscope to diagnose breast cancer and other breast diseases.
Breast cancer is cancer that forms in the milk ducts (tubes that carry milk to the nipple) and the lobules (the small lobes of breast tissue that make milk). Breast cancer is much more common in women, but men can get it, too. Not much is known about breast cancer risk in transgender people. If you are transgender, talk with your provider about your risk.
There are different ways to do a breast biopsy. Some methods remove breast tissue with a needle and others use a small incision (cut) in your skin to remove part or all of the suspicious tissue.
Most people who need a breast biopsy don't have cancer.
Other names: core needle biopsy; core biopsy, breast; fine-needle aspiration; open surgery biopsy
A breast biopsy is the only way to find out whether a suspicious change in your breast is cancer. You may have a biopsy after other breast tests, such as a physical breast exam or a mammogram, show signs that could be breast cancer.
You may need a breast biopsy if:
You or your health care provider felt a lump, thickening, or other change in your breast.
A mammogram, ultrasound, or MRI test shows a lump, calcium deposits, or other signs that might mean cancer.
The skin on your breast or nipple is red, scaly, or swollen, or your nipple is pulled inward.
You have a discharge of abnormal fluid coming from your nipple.
If your provider suggests that you have a breast biopsy, it doesn't mean you have breast cancer. Most breast lumps and other changes that are checked with biopsies turn out to be benign, which means they are not cancer.
There are three main types of breast biopsy procedures. They are usually done on an outpatient basis, which means you go home the same day:
Fine needle aspiration biopsy uses a very thin needle to remove a sample of breast cells or fluid. The biopsy takes about 15 minutes.
Core needle biopsy uses a wide needle to remove one or more small tissue samples about the size of a grain of rice. Sometimes a small vacuum probe is used instead of a needle. The device gently suctions some tissue and removes it with a small rotating blade. A core needle biopsy takes between 15 minutes and an hour, depending on how it's done.
Surgical biopsy (or open biopsy) is surgery to remove all or part of a lump. The biopsy usually takes about an hour.
Biopsies are often done using mammography, ultrasound, MRI, or x-rays to help see exactly where to take the tissue sample. Your procedure will vary depending on which method is used to guide the biopsy, but the general steps are usually the same.
For a fine needle aspiration biopsy or a core needle biopsy:
Your provider will clean the skin on your breast and give you a shot of medicine to numb the area, so you won't feel any pain. The shot may sting briefly.
You may be sitting or lying down. If images are used to guide the biopsy, you may lie on your side, back, or belly with your breast over an opening on the table.
For a fine needle aspiration biopsy, your provider will insert the needle into the biopsy site and remove a sample of cells or fluid. For a core biopsy, a tiny cut may be made to insert a wide needle or a vacuum device. You may feel a little pressure when the sample or samples are removed.
Pressure will be applied to area until the bleeding stops.
Your provider will cover the biopsy site with a sterile bandage. If you had a small incision, small strips of medical tape may be used to close the wound.
For a surgical biopsy:
You'll lie on an operating table. You may have an IV (intravenous line) in your arm or hand that may be used to give you medicine to relax. The skin over the biopsy area will be cleaned.
To prevent pain, you'll have either:
A shot of medicine to numb your breast. The shot may sting briefly.
General anesthesia, which is medicine given through an IV to make you sleep.
When you are numb or asleep, the surgeon will make a small cut in your breast tissue to remove part or all of the lump. In certain cases, tissue around the lump may also be removed. This may help avoid the need for more surgery if cancer cells are found in the lump.
The cut in your skin will be closed with small strips of medical tape or stitches and covered with a sterile bandage.
The type of biopsy you have will depend on:
The size and location of the suspicious tissue in your breast
How many areas of your breast are involved
How abnormal the tissue looks on a mammogram or other image
Your general health and preferences
Ask your provider about why you need a biopsy and which type is right for you.
Your provider will give you instructions for how to prepare for your biopsy. If you take any blood thinners, including aspirin, you may need to stop taking them before your biopsy. Tell your provider about all the medicines and supplements you take. Don't stop or start taking anything without talking with your provider first.
If you're having general anesthesia, you will probably need to fast (not eat or drink) for several hours before surgery. If you have general anesthesia or medicine to relax, you may be groggy after the procedure, so plan to have someone take you home.
It's common to have some bruising and temporary discomfort after a breast biopsy. Possible risks include:
Infection, which can be treated with antibiotics
Bleeding
Your provider will give you instructions for how to care for biopsy area and manage any discomfort. If you're having general anesthesia, talk with your provider about how it may affect you. General anesthesia is very safe even for most people with other health conditions.
It may take several days to a week to get your biopsy results. The results are called a pathology report. The report is written for your provider and will include a lot of medical terms. Your provider can explain what your report means.
The most important part of your report will be the diagnosis. In general, your results will be one of these categories:
Normal. No cancer or abnormal cells were found.
Abnormal breast changes that aren't cancer and don't increase your risk for breast cancer. Some of these conditions often get better on their own and others may need treatment.
Abnormal breast changes that increase your risk for breast cancer. These cells are not cancer, but if you have them, you are more likely to develop cancer.
If you had a needle biopsy that diagnosed a condition that increases your breast cancer risk, you may need a surgical biopsy to remove all the abnormal tissue. To find out what you can do to reduce your breast cancer risk, you will likely see a doctor who specializes in breast cancer.
Breast cancer. If your biopsy finds cancer cells, your report will include details about how fast the cancer cells are growing, how much they look like normal cells, and other information to help plan the most effective treatment for your type of cancer. Usually, a doctor who specializes in breast cancer will provide your care.
Breast Biopsy: MedlinePlus Medical Test [accessed on Mar 22, 2022]
Having a Breast Biopsy | Effective Health Care (EHC) Program [accessed on Mar 22, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (13)
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Video by PreOp.com Patient Engagement - Patient Education/YouTube
How a core breast biopsy is taken
Video by Bupa Health UK/YouTube
Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital
Video by UPMC/YouTube
What It’s Like to Get a Breast Biopsy
Video by RAYUS Radiology™/YouTube
Ultrasound-guided core-needle breast biopsy
Video by Institute for Cancer Genetics and Informatics/YouTube
Having a breast biopsy. A review of the research for women and thier families (2016 report)
This information is right for you if: -- You are a woman. The information in this summary is from
research on women. -- Your doctor has found a breast lump or shadow on your mammogram and has recommended a breast biopsy.
Document by effectivehealthcare.ahrq.gov
Ultrasound Guided Breast Biopsy 1
Ultrasound image of possible breast tumor before biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
Image by TheVisualMD
Ultrasound Guided Breast Biopsy 2
Ultrasound image of possible breast tumor showing core needle penetrating suspicious breast lesion during biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
Image by TheVisualMD
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Needle Biopsy
Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Biopsy
A Caucasian woman patient is being operated on. Her nipple is being incised by the surgeon. The male surgeon and an operating room attendant are visible. A surgical biopsy is being performed to determine exact nature of solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Breast Biopsy
Image Caption : Needle Breast Biopsy
Image by BruceBlaus
Mammotome
Mammotome probe - biopsy
Image by Waglione/Wikimedia
This browser does not support the video element.
Breast Cancer Biopsy
If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)
Video by TheVisualMD
2:22
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Stereotactic Biopsies for Breast Evaluation | UPMC Magee-Womens Hospital
UPMC/YouTube
3:57
What It’s Like to Get a Breast Biopsy
RAYUS Radiology™/YouTube
1:29
Ultrasound-guided core-needle breast biopsy
Institute for Cancer Genetics and Informatics/YouTube
Having a breast biopsy. A review of the research for women and thier families (2016 report)
effectivehealthcare.ahrq.gov
Ultrasound Guided Breast Biopsy 1
TheVisualMD
Ultrasound Guided Breast Biopsy 2
TheVisualMD
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Needle Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
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Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
Breast Biopsy
BruceBlaus
Mammotome
Waglione/Wikimedia
0:56
Breast Cancer Biopsy
TheVisualMD
Cervical Biopsy
Cervical Biopsy
Also called: Biopsy - Cervix
A cervical biopsy is a medical procedure in which a small sample of the cervix (the uppermost portion of the vagina that connects with the uterus) is taken and then sent to a specialist to see if there are any cancerous cells or other abnormalities present in it.
Cervical Biopsy
Also called: Biopsy - Cervix
A cervical biopsy is a medical procedure in which a small sample of the cervix (the uppermost portion of the vagina that connects with the uterus) is taken and then sent to a specialist to see if there are any cancerous cells or other abnormalities present in it.
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Your result is Normal.
A normal result means that no cancerous cells or other abnormal cells were found and you don't need any immediate treatment.
Related conditions
The cervix is the uppermost portion of the vagina that is connected with the uterus. The outer surface of the cervix is covered with a layer of skin-like cells (epithelial cells), and it’s called ectocervix. While, the lining of the cervical canal is covered with glandular cells that produce mucus, and it’s known as endocervix.
A cervical biopsy is a procedure in which a small sample of tissue from the cervix (usually from both the ectocervix and endocervix) is taken and then sent to a pathologist to see if there are any cancerous cells or other abnormalities present in it.
This procedure is often done as part of a colposcopy, which is a diagnostic test where a special device known as colposcope is used to examine the cervix, vagina, and vulva to look for microscopic signs of disease.
Your doctor may want to order a cervical biopsy in the following situations:
If your Pap results were abnormal. A Pap test screens for any cell changes on your cervix
If your cervix looks abnormal during a routine pelvic exam
If you have been diagnosed with human papillomavirus (HPV)
This test may also be used to diagnose and help treat certain conditions, such as cervical polyps (benign growths on the cervix) and cervical warts.
A healthcare practitioner will ask you to lie on your back on an exam table; then a sterile speculum will be inserted in your vagina to visualize your cervix, and the colposcope will be used to observe your cervical cells.
Next, a cotton swab will be used to apply a solution of vinegar or iodine on your cervix. This will make any potentially abnormal tissue visible. A local anesthetic will be injected into your cervix, and the biopsy will be taken.
The type of biopsy that your healthcare professional choose to perform will depend on the size, shape, and location of the abnormal cells. Types of cervical biopsies include:
Punch biopsy: in this procedure, a circular blade is used to remove the tissue samples. It is somewhat similar to a paper hole puncher.
Cone biopsy: in this procedure, a large cone-shaped piece of cervical tissue is removed by using a laser or blade.
Endocervical curettage (ECC): in this procedure, a narrow instrument called a curette is used to scrape cells from the endocervix.
After the biopsy is taken, your healthcare practitioner will apply a paste-like topical medicine on your cervix to stop the bleeding.
You will be asked to empty your bladder before the procedure. Tell your doctor if there is any chance that you may be pregnant. If there is any uncertainty, you will need to take a pregnancy test beforehand.
Do not use vaginal medicines, douche, tampons, or have sex for at least 48 hours before the procedure. Make sure to inform your healthcare practitioner if you are allergic to iodine or latex.
You may be asked to take an over-the-counter pain reliever 30 minutes before the procedure to minimize any potential discomfort.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
You may feel some cramping, discomfort, and vaginal spotting during and after the procedure.
Do not insert anything on your vagina or have sex after a cone biopsy procedure until your doctor tells you otherwise. Cone biopsies may increase the risk for infertility and miscarriage.
A cervical biopsy is normal when no cancerous cells or other abnormal cells are found.
An abnormal result can be reported using different systems to describe dysplasia, which is the technical word used to describe abnormal cell changes:
Mild dysplasia: this means that your cervical cells look slightly different from normal cells.
Moderate dysplasia: this means that your cervical cells look quite different from normal cells.
Severe dysplasia: this means that your cervical cells look very different from normal cells, which indicates a higher risk for cancer.
Cervical intraepithelial neoplasia (CIN)
Another way to describe abnormal cell changes in the cervix is the cervical intraepithelial neoplasia (CIN) grading system.
CIN is the name given to cellular changes to the ectocervix; while, cervical glandular intraepithelial neoplasia (CGIN) refers to abnormal changes to the endocervix. CGIN less common than CIN, but it is treated similarly.
CIN 1: is used for low-grade changes in the cervical cells. It’s the least severe, and it compares to mild dysplasia.
CIN 2: is used for moderate changes in the cervical cells. It’s moderately severe, and it compares to moderate dysplasia.
CIN 3: is used for high-grade changes in the cervical cells. It’s the most severe, and it describes both severe dysplasia and carcinoma in situ (very early stage of cancer)
Squamous intraepithelial lesion (SIL)
The most common way to describe abnormal squamous cell changes in the cervix is the squamous intraepithelial lesion (SIL) grading system. SIL is described as low grade or high grade.
Low-grade SIL (LSIL): compares to mild dysplasia and CIN 1.
High-grade SIL (HSIL): compares to moderate and severe dysplasia and to CIN 2 and CIN 3.
https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results [accessed on Dec 27, 2018]
Cervical Biopsy - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 27, 2018]
Canadian Cancer Society [accessed on Dec 27, 2018]
Abnormal Cervical Cells: CIN & CGIN | Jo's Cervical Cancer Trust [accessed on Dec 27, 2018]
Types and Stages of Cervical Cancer | Jo's Cervical Cancer Trust [accessed on Jan 03, 2019]
Reporting For Cervical Biopsy Specimens [accessed on Jan 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Colposcopy
Colposcopy
Also called: Colposcopy with directed biopsy
A colposcopy allows a provider to get a close-up view of a woman's cervix, vagina, and vulva. It uses a magnifying device placed near, but not inside, the vagina. If abnormal cells are found, a biopsy may be performed.
Colposcopy
Also called: Colposcopy with directed biopsy
A colposcopy allows a provider to get a close-up view of a woman's cervix, vagina, and vulva. It uses a magnifying device placed near, but not inside, the vagina. If abnormal cells are found, a biopsy may be performed.
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Use the slider below to see how your results affect your
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Your result is Negative.
Negative colposcopy results are normal and indicate that no abnormal changes were found.
Related conditions
A colposcopy is a procedure that allows a health care provider to closely examine a woman's cervix, vagina, and vulva. It uses a lighted, magnifying device called a colposcope. The device is placed at the opening of the vagina. It magnifies the normal view, allowing your provider to see problems that can't be seen by the eyes alone.
If your provider sees a problem, he or she may take a sample of tissue for testing (biopsy). The sample is most often taken from the cervix. This procedure is known as a cervical biopsy. Biopsies may also be taken from the vagina or vulva. A cervical, vaginal, or vulvar biopsy can show if you have cells that are at risk for becoming cancer. These are called precancerous cells. Finding and treating precancerous cells may prevent cancer from forming.
A colposcopy is most often used to find abnormal cells in the cervix, vagina, or vulva. It may also be used to:
Check for genital warts, which may be a sign of an HPV (human papillomavirus) infection. Having HPV may put you at higher risk for developing cervical, vaginal, or vulvar cancer.
Look for noncancerous growths called polyps
Check for irritation or inflammation of the cervix
If you've already been diagnosed and treated for HPV, the test may be used to monitor cell changes in the cervix. Sometimes abnormal cells return after treatment.
You may need this test if you had abnormal results on your Pap smear. A Pap smear is a test that involves getting a sample of cells from the cervix. It can show if there are abnormal cells, but it can't provide a diagnosis. A colposcopy provides a more detailed look at the cells, which may help your provider confirm a diagnosis and/or find other potential problems.
You may also need this test if:
You have been diagnosed with HPV
Your provider sees abnormal areas on your cervix during a routine pelvic exam
You have bleeding after sex
A colposcopy may be done by your primary care provider or by a gynecologist, a doctor who specializes in diagnosing and treating diseases of the female reproductive system. The test is usually done in the provider's office. If abnormal tissue is found, you may also get a biopsy.
During a colposcopy:
You will remove your clothing and put on a hospital gown.
You will lie on your back on an exam table with your feet in stirrups.
Your provider will insert a tool called a speculum into your vagina. It is used to spread open your vaginal walls.
Your provider will gently swab your cervix and vagina with a vinegar or iodine solution. This makes abnormal tissues easier to see.
Your provider will place the colposcope near your vagina. But the device will not touch your body.
Your provider will look through the colposcope, which provides a magnified view of the cervix, vagina, and vulva. If any areas of tissue look abnormal, your provider may perform a cervical, vaginal, or vulvar biopsy.
During a biopsy:
A vaginal biopsy can be painful, so your provider may first give you a medicine to numb the area.
Once the area is numb, your provider will use a small tool to remove a sample of tissue for testing. Sometimes many samples are taken.
Your provider may also do a procedure called an endocervical curettage (ECC) to take a sample from the inside of the opening of the cervix. This area can't be seen during a colposcopy. An ECC is done with a special tool called a curette. You may feel a slight pinch or cramp as the tissue is removed.
Your provider may apply a topical medicine to the biopsy site to treat any bleeding you may have.
After a biopsy, you should not douche, use tampons, or have sex for a week after your procedure, or for as long as your health care provider advises.
Do not douche, use tampons or vaginal medicines, or have sex for at least 24 hours before the test. Also, it's best to schedule your colposcopy when you are not having your menstrual period. And be sure to tell your provider if you are pregnant or think you may be pregnant. Colposcopy is generally safe during pregnancy, but if a biopsy is needed, it can cause extra bleeding.
There is very little risk to having a colposcopy. You may have some discomfort when the speculum is inserted into the vagina, and the vinegar or iodine solution may sting.
A biopsy is also a safe procedure. You may feel a pinch when the tissue sample is taken. After the procedure, your vagina may be sore for a day or two. You may have some cramping and slight bleeding. It's normal to have a little bleeding and discharge for up to a week after the biopsy.
Serious complications from a biopsy are rare, but call your provider if you have any of the following symptoms:
Heavy bleeding
Abdominal pain
Signs of infection, such as fever, chills and/or bad smelling vaginal discharge
During your colposcopy, your provider may find one or more of the following conditions:
Genital warts
Polyps
Swelling or irritation of the cervix
Abnormal tissue
If your provider also performed a biopsy, your results may show you have:
Precancerous cells in the cervix, vagina, or vulva
An HPV infection
Cancer of the cervix, vagina, or vulva
If your biopsy results were normal, it's unlikely that you have cells in your cervix, vagina, or vulva that are at risk for turning into cancer. But that can change. So your provider may want to monitor you for cell changes with more frequent Pap smears and/or additional colposcopies.
If you have questions about your results, talk to your health care provider.
If your results showed you have precancerous cells, your provider may schedule another procedure to remove them. This may prevent cancer from developing. If cancer was found, you may be referred to a gynecologic oncologist, a provider who specializes in treating cancers of the female reproductive system.
Colposcopy - NHS [accessed on Dec 27, 2018]
What Is A Colposcopy? - When to See a Doctor | familydoctor.org [accessed on Dec 27, 2018]
Colposcopy: What You Need to Know | One Medical [accessed on Dec 27, 2018]
Colposcopy & Cervical Biopsy: Purpose, Procedure, Results & HPV [accessed on Jan 03, 2019]
Colposcopy - Mayo Clinic [accessed on Jan 03, 2019]
Colposcopic evaluation of men with genital warts. - PubMed - NCBI [accessed on Jan 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
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HPV: E6 E7mRNA: HPV E6 E7 mRNA and Pap Tests
Pap tests (ie, cervical cytology) are the most common way to screen for cervical cancer and routine Pap testing is credited with widely reducing the incidence of cervical cancer since the tests implementation. Pap tests are, however, limited by their relatively low sensitivity and specificity. Studies suggest that testing for high-risk HPV DNA is a more sensitive method of determining a woman's risk of developing cervical cancer. Though current high-risk HPV DNA testing methods provide adequate sensitivity, specificity is lacking, which can lead to false-positive results and unnecessary invasive procedures such as colposcopy and biopsy. Its important for every woman to talk to her doctor about what tests are right for her.
Image by TheVisualMD
Colposcopy
Image of Colposcope
Image by S. Kellam
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HPV E6 E7 mRNA and Pap Tests
HPV E6 E7 mRNA and Pap Tests: Pap tests (ie, cervical cytology) are the most common way to screen for cervical cancer and routine Pap testing is credited with widely reducing the incidence of cervical cancer since the tests implementation. Pap tests are, however, limited by their relatively low sensitivity and specificity.Studies suggest that testing for high-risk HPV DNA is a more sensitive method of determining a woman`s risk of developing cervical cancer. Though current high-risk HPV DNA testing methods provide adequate sensitivity, specificity is lacking, which can lead to false-positive results and unnecessary invasive procedures such as colposcopy and biopsy. Its important for every woman to talk to her doctor about what tests are right for her.
Image by TheVisualMD
HPV
19-year-old woman with no previous Paps in house. I called it ASC-US based on this single group on ThinPrep (1000X). The rest of the slide was negative, even in retrospect. The case reflexed to HPV by Hybrid Capture, which was positive for high-risk HPV. Colposcopy was done.
Image by Ed Uthman
Endoscopy
Instruments used in endoscopy. They are highlighted in an otherwise dark setting and lying on a textured cloth. Flexible fibers, a small brush and a third instrument. The fibers transmit high intensity light through the endoscope shown. The brushes are used to take biopsies.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Diethylstilbestrol (DES) Cervix
A Metaplastic squamous epithelium that is glycogen poor (top), adjacent to normal squamous epithelium that is glycogen rich (bottom). The corresponding regions would fail to stain with iodine (top) or would take up the stain (bottom) . The squamous pegs in the lamina propria represent glands replaced entirely by metaplastic squamous epithelium (H&E, x45). The lower half of the photograph illustrates the junction of metaplastic squamous epithelium (left) adjacent to normal squamous epithelium (right). The hyperkeratosis on the left would appear as leukoplakia on colposcopy (H&E, x 250).
Image by National Cancer Institute / Unknown Photographer
Diethylstilbestrol (DES) Cervix
Metaplastic squamous adjacent to normal squamous apithelium that is glycogen rich. The squamous pegs in the lamina propria represent glands replaced entirely by metaplastic squamous epithelium (H&E, x45). This of the photograph illustrates the junction of metaplastic squamous epithelium (left) adjacent to normal squamous epithelium (right). The hyperkeratosis on the left would appear as leukoplakia on colposcopy (H&E, x 250).
Image by National Cancer Institute / Unknown Photographer
NHS Cervical Cancer Screening Module 3
Video by ASKVisualScience/YouTube
What is Cervical dysplasia?
Video by HealthFeed Network/YouTube
NHS Cervical Cancer Screening Module 1
Video by ASKVisualScience/YouTube
NHS Cervical Cancer Screening Module 2
Video by ASKVisualScience/YouTube
Cervical Cancer Screening Module 4
Video by ASKVisualScience/YouTube
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HPV: E6 E7mRNA: HPV E6 E7 mRNA and Pap Tests
TheVisualMD
Colposcopy
S. Kellam
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HPV E6 E7 mRNA and Pap Tests
TheVisualMD
HPV
Ed Uthman
Endoscopy
National Cancer Institute / Linda Bartlett (Photographer)
Diethylstilbestrol (DES) Cervix
National Cancer Institute / Unknown Photographer
Diethylstilbestrol (DES) Cervix
National Cancer Institute / Unknown Photographer
2:11
NHS Cervical Cancer Screening Module 3
ASKVisualScience/YouTube
1:35
What is Cervical dysplasia?
HealthFeed Network/YouTube
1:33
NHS Cervical Cancer Screening Module 1
ASKVisualScience/YouTube
1:45
NHS Cervical Cancer Screening Module 2
ASKVisualScience/YouTube
1:26
Cervical Cancer Screening Module 4
ASKVisualScience/YouTube
Endometrial Biopsy
Endometrial Biopsy
Also called: Biopsy - Endometrium
An endometrial biopsy is a procedure that removes a small sample of endometrium tissue (the lining of the uterus) for testing. The tissue is looked at under a microscope to check for abnormal cells.
Endometrial Biopsy
Also called: Biopsy - Endometrium
An endometrial biopsy is a procedure that removes a small sample of endometrium tissue (the lining of the uterus) for testing. The tissue is looked at under a microscope to check for abnormal cells.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
This means that no cancerous cells or other abnormal cells are found.
Related conditions
The endometrium is the layer of the uterus that sheds during the normal menstrual cycle, and it’s where the embryo implantation takes place during pregnancy.
An endometrial biopsy is a procedure in which a small sample of tissue from the endometrium is taken and then sent to a pathologist to see if there are any cancerous cells or other abnormalities present in it.
Your doctor may want to order this test is the following situations:
To help assess the cause of infertility
If you have heavy or unusually long menstrual periods
If your menstrual cycle is irregular
If you have vaginal bleeding after the menopause
If a pelvic ultrasound has shown that you have a thickened uterine lining
After applying a mild sedative, or giving you an over-the-counter medication to minimize any potential discomfort, a healthcare practitioner will ask you to lie on your back on an exam table; then a sterile speculum will be inserted in your vagina to visualize your cervix (the uppermost portion of your vagina).
After cleaning and numbing your cervix, a thin rod-like instrument, known as a uterine sound, is carefully inserted through it to measure the length of your uterus and find the location for biopsy.
The uterine sound is removed, and then a very thin and flexible tool called catheter is inserted through the cervix to gently suction out a tissue sample from the endometrium.
This procedure usually lasts no more than 20 minutes, after which you are cleared to go home.
You will be asked to empty your bladder before the procedure. Tell your doctor if there is any chance that you may be pregnant. If there is any uncertainty, you will need to take a pregnancy test beforehand.
Inform your healthcare practitioner about any over-the-counter or prescription medications that you are taking, as well of any chronic pelvic infection or untreated sexually transmitted infection that you may have.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
You may feel some cramping, discomfort, and vaginal spotting during and after the procedure.
An endometrial biopsy is normal when no cancerous cells or other abnormal cells are found.
Results are considered abnormal when any of the following findings are present:
Benign (noncancerous) growths, such as polyps or fibroids
A uterine infection, like endometritis
Endometrial hyperplasia, which is a thickening of the endometrium
Endometrial cancer
Your results might also come back as inconclusive. In this case, further testing, such as dilation and curettage (D&C), may be required.
Endometrial biopsy cannot be performed on pregnant women or those who are suffering from untreated vaginal, cervical, or tubal infection.
Endometrial Biopsy Test Details | Cleveland Clinic [accessed on Dec 27, 2018]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07773 [accessed on Dec 27, 2018]
Endometrial Biopsy: Purpose, Procedure, and Risks [accessed on Dec 27, 2018]
Endometrial Biopsy | Johns Hopkins Medicine Health Library [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (16)
Dilation and Curettage
An illustration of the dilation and curettage medical procedure
Image by Fred the Oyster
Symptoms, Causes, Risk of pregnancy loss/miscarriage
A 13-week fetus without cardiac activity located in the uterus (delayed or missed miscarriage)
Image by Mikael Haggstrom
Endometrial Cancer | Did You Know?
Video by National Cancer Institute/YouTube
Mayo researchers developing new way to screen for endometrial cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
Video by PreOp.com Patient Engagement - Patient Education/YouTube
Pelvic Diseases: Uterine Cancer
Video by AFMSCEMMTube/YouTube
The Facts on Miscarriages (Getting Pregnant #6)
Video by Healthguru/YouTube
How to Recover from a Miscarriage
Video by Howcast/YouTube
What Causes Miscarriage | Parents
Video by Parents/YouTube
What is endometrial cancer? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Uterus
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by BruceBlaus
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Uterus
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by National Cancer Institute
Human female reproductive system
Uterus and Nearby Organs Description The uterus and nearby organs in the female reproductive tract (ovaries, fallopian tubes, cervix, and vagina). An inset provides a close-up view of the layers of the tissue in the uterus (myometrium and endometrium).
Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Implantation
During implantation, the trophoblast cells of the blastocyst adhere to the endometrium and digest endometrial cells until it is attached securely.
Image by CNX Openstax
Uterus with Uterine Cancer
Medical visualization of an anterior cross-sectional view of a uterus with advanced uterine cancer, the most common gynecologic cancer. The most common form of uterine cancer is endometrial cancer (90%+), which originates from the lining of the uterus (endometrium.) Far less common is uterine sarcoma, which originates from the outer layer of muscle (myometrium.)
Image by TheVisualMD
Estrogen Molecule
Medical visualization of an estrogen molecule. Estrogen, as with all of the other main sex hormones, is a steroid hormone derived from cholesterol. Along with progesterone, estrogen is one of the most important female sex hormones. Estrogen production is primarily located in the developing follicles in the ovaries, called the corpus luteum, and the placenta. Another main site of estrogen production is fatty tissue, making weight a contributing factor to the timing of puberty. Smaller amounts are produced by other tissues such as the the breasts, liver, and adrenal glands. Estrogen is responsible for female secondary sexual characteristics such as breast growth, as well as aspects of menstrual cycle regulation, such as the thickening of the endometrium. As with all sex hormones, the effects of estrogen aren't limited to reproduction; estrogen affects bone growth and is involved with learning and memory. Both men and women have all of the main sex hormones, but in very different amounts. Women have much more estrogen than men, but some research suggests that estrogen may be essential for maintenance of the male libido, or sex drive.
Image by TheVisualMD
Dilation and Curettage
Fred the Oyster
Symptoms, Causes, Risk of pregnancy loss/miscarriage
Mikael Haggstrom
2:53
Endometrial Cancer | Did You Know?
National Cancer Institute/YouTube
1:43
Mayo researchers developing new way to screen for endometrial cancer - Mayo Clinic
Mayo Clinic/YouTube
3:12
Dilation and Curettage D & C Surgery PreOp® Patient Engagement and Education
What is endometrial cancer? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
Uterus
BruceBlaus
Sensitive content
This media may include sensitive content
Uterus
National Cancer Institute
Human female reproductive system
Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Implantation
CNX Openstax
Uterus with Uterine Cancer
TheVisualMD
Estrogen Molecule
TheVisualMD
Kidney Biopsy
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
Kidney Biopsy
Also called: Renal Biopsy, Biopsy - Kidney
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. The tissue is examined for signs of kidney disease or infection. It can also be used to check for cancer or other abnormalities.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result is when the kidney tissue shows normal structure.
Related conditions
A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a microscope. A pathologist—a doctor who specializes in diagnosing diseases—examines the kidney tissue sample in a lab. The pathologist looks for signs of kidney disease or infection. If the kidney has been transplanted and is not working, a kidney biopsy may help identify the cause.
A health care provider will perform a kidney biopsy to evaluate any of the following conditions:
hematuria—blood in the urine, which can be a sign of kidney disease or other urinary problems.
albuminuria—a condition in which the urine has more-than-normal amounts of a protein called albumin. Albuminuria may be a sign of kidney disease.
changes in kidney function, which can cause the buildup of waste products in the blood.
Health care providers may use a kidney biopsy to diagnose cancer. If cancer is present, there is a small chance that the biopsy needle will spread the cancer. In addition, the biopsy specimen is very small and may miss the cancer and, therefore, may not provide the right diagnosis.
A kidney biopsy is usually done in a hospital. An overnight stay may be needed to watch for any problems. You may be awake with only light sedation, or asleep under general anesthesia. You will be lying face down with a pillow under your rib cage. If the biopsy is done on a transplanted kidney, you will be lying on your back.
To prepare for a kidney biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about about food or medication restrictions.
The risks of a kidney biopsy include
bleeding—the most common complication of a kidney biopsy. Bleeding may come from the kidney or the puncture site. Bleeding from the kidney rarely requires a blood transfusion.
infection—a rare complication of a kidney biopsy. Health care providers prescribe bacteria-fighting medications called antibiotics to treat infections.
The kidney tissue sample can show inflammation, scarring, infection, or unusual deposits of a protein called immunoglobulin. If a person has chronic kidney disease—any condition that causes reduced kidney function over a period of time—the biopsy may show how quickly the disease is advancing. A biopsy can also help explain why a transplanted kidney is not working properly.
https://www.niddk.nih.gov/health-information/diagnostic-tests/kidney-biopsy [accessed on Feb 19, 2019]
https://medlineplus.gov/ency/article/003907.htm [accessed on Feb 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (17)
Pyelonephritis (Kidney Infection)
Pain caused by Pyelonephritis
Image by Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
Drawing of the urinary tract in the outline of a male figure. The kidneys, ureters, and bladder are labeled. An inset image from one of the kidneys shows simple cysts as raised bumps on the kidney. The simple cysts and ureter are labeled. Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys.
Image by NIDDK Image Library
Kidney with ACKD
Drawing of a male torso with kidneys, ureters, bladder, and urethra labeled, and a drawing below of a kidney with sacs of fluid labeled as cysts. Acquired cystic kidney disease happens when a person's kidneys develop fluid-filled sacs called cysts.
Image by National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
The healthy kidney on the lower right is smooth. The polycystic kidney on the upper left has many fluid-filled sacs on the surface. Labels point to the ureter and cysts on the polycystic kidney. The polycystic kidney roughly retains the same shape as the healthy kidney.
Image by NIDDK Image Library
Peritoneal dialysis
Outline of a male figure receiving peritoneal dialysis. Labels point to the dialysis solution, catheter, space inside the belly, lining of the belly and tube to drain bag.
Image by NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
Drawing of the kidneys and urinary tract within the outline of a young boy. The kidneys, ureters, and bladder are labeled. The kidneys remove wastes and extra water from the blood to form urine.Urine flows from the kidneys to the bladder through the ureters.
Image by NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
Front-view drawing of a normal urinary tract in an infant. The kidneys, ureters, bladder, and urethra are labeled. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra.
Image by NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
Drawing of a pelvic ectopic kidney labeled, showing the pelvis, bladder, ureters, and kidneys. The kidney on the right is in the normal position, several inches above the bladder. The kidney on the left is an ectopic kidney, just a couple of inches above the bladder. An ectopic kidney may remain in the pelvis, near the bladder.
Image by NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
Drawing of a fused ectopic kidney, showing the pelvis, bladder, ureters, and fused kidneys. The kidney that would normally be on the left has crossed over and fused with the kidney on the right. An ectopic kidney may cross over and become fused with the other kidney.
Image by NIDDK Image Library
Drawing of pelvic ectopic kidney
An ectopic kidney may remain in the pelvis, close to the bladder.
Image by NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. People born with kidney dysplasia have both kidneys; however, one kidney does not function (top right). When a kidney is removed surgically due to disease or for donation, both the kidney and ureter are removed (bottom right).
Image by NIDDK Image Library
Solitary Kidney
Drawing of one kidney and the bladder.
Image by NIDDK Image Library
Healthy vs Damaged Kidney
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
Urine Test for Albumin
If you are at risk for kidney disease, your provider may check your urine for albumin.
Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria.
A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine.
A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.
A health care provider can check for albumin in your urine in two ways:
Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine.
Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of
30 mg/g or less is normal
more than 30 mg/g may be a sign of kidney disease
If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you.
If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.
Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Kidney and Urinary System
3D visualization reconstructed from scanned human data of the urinary system revealing anterior view of the kidneys, ureters and bladder. The urinary system is responsible for fluid balance and waste excretion. Blood enters the kidneys where waste products are excreted to form a fluid called filtrate. Filtrate continues to collect additional waste products and minerals as it travels through the winding tubules of the kidney. Eventually the filtrate becomes urine as it is channeled out of the kidney, into the ureters, down to the bladder and eventually out through the urethra to the external body.
Image by TheVisualMD
Right Kidney and Ureter
3D visualization based on scanned human data of the right kidney.
Image by TheVisualMD
Kidney with Blood Vessel
This 3D visualization reveals the vasculature of a kidney. Kidneys help to remove excess water and salts from the body and lower the volume of blood by producing the waste product, urine.
Image by TheVisualMD
Drawing of a kidney with an inset of a nephron
The glomeruli are sets of looping blood vessels in nephrons--the tiny working units of the kidneys that filter wastes and remove extra fluid from the blood.
Image by NIDDK Image Library
Pyelonephritis (Kidney Infection)
Grook Da Oger
Drawing of the urinary tract showing simple kidney cysts (male figure)
NIDDK Image Library
Kidney with ACKD
National Institute of Diabetes and Digestive and Kidney Diseases
Diagram of two kidneys (healthy vs polycystic)
NIDDK Image Library
Peritoneal dialysis
NIDDK Image Library
Kidneys and urinary tract within the outline of a young boy
NIDDK Image Library
Front-view drawing of a normal urinary tract in an infant
NIDDK Image Library
Drawing of a pelvic ectopic kidney labeled
NIDDK Image Library
Drawing of a fused ectopic kidney, labeled
NIDDK Image Library
Drawing of pelvic ectopic kidney
NIDDK Image Library
Drawing of urinary tract in an outline of the top half of a human body. Inset of one kidney and the bladder and one kidney, nonworking kidney, and the bladder
NIDDK Image Library
Solitary Kidney
NIDDK Image Library
Healthy vs Damaged Kidney
The National Institute of Diabetes and Digestive and Kidney Diseases/NIH
Kidney and Urinary System
TheVisualMD
Right Kidney and Ureter
TheVisualMD
Kidney with Blood Vessel
TheVisualMD
Drawing of a kidney with an inset of a nephron
NIDDK Image Library
Liver Biopsy
Liver Biopsy
Also called: Biopsy of the Liver
A liver biopsy is a procedure that removes a small sample of liver tissue for testing. The tissue is looked at under a microscope to check for signs of damage or disease.
Liver Biopsy
Also called: Biopsy of the Liver
A liver biopsy is a procedure that removes a small sample of liver tissue for testing. The tissue is looked at under a microscope to check for signs of damage or disease.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The liver tissue is normal.
Related conditions
A liver biopsy is a procedure in which a doctor takes a small piece of tissue from your liver. A pathologist will examine the tissue with a microscope to look for signs of damage or disease. A biopsy can be done in different ways.
Doctors use liver biopsy to
diagnose liver diseases when doctors can’t confirm a diagnosis with blood or imaging tests
find out how severe the liver damage or disease is
help determine the best treatment for liver damage or disease
find out how a treatment for liver disease is working
Doctors perform a liver biopsy at a hospital or outpatient center. Depending on the liver biopsy type, doctors take the sample of liver tissue in a different way.
Procedures used to collect the sample of cells or tissues include:
Percutaneous liver biopsy: A procedure in which a long needle is introduced through the skin of your chest or abdomen. The needle removes 2 or 3 small samples of liver tissue. This procedure is usually performed on an outpatient basis. If you have a history of bleeding problems your doctor may want to perform a transjugular biopsy.
Transjugular liver biopsy: A transjugular liver biopsy is often advised for people who have a problem with blood clotting or a large amount of fluid in their abdomen. It is done by an interventional radiologist, a doctor who specializes in this type of procedure. During a transjugular biopsy your doctor will insert a small tube into your jugular (neck) vein. X-rays will help guide the tube into a large vein in your liver. A small needle is inserted through the tube and into your liver. The needle removes 2 or 3 small samples of tissue.
Laparoscopic liver biopsy: This is where a special instrument known as a laparoscope, which allows doctors to view the liver (done in the OR by a surgeon), is inserted through a small cut in your abdomen. The laparoscope is a small tube with a camera on the end. The doctor will use instruments attached to the laparoscope to remove tissue samples from your liver. This technique is useful when the doctor wants to take a biopsy from a specific part of the liver. This is the least common type of liver biopsy.
To prepare for a liver biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about fasting before the procedure.
The risks of liver biopsy include complications such as the following:
Internal bleeding
Pain
Infection
Collapsed lung
Complications from the sedation
Injury to the gallbladder or kidney
A liver biopsy shows how much scarring your liver has and will help your health care provider figure out what is causing the damage and how best to treat it.
Liver Biopsy | NIDDK [accessed on Jan 08, 2019]
Liver biopsy: MedlinePlus Medical Encyclopedia [accessed on Jan 08, 2019]
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=92&contentid=P07696 [accessed on Jan 08, 2019]
https://www.hepatitis.va.gov/basics/liver-damage-tests.asp [accessed on Jan 08, 2019]
https://www.ncbi.nlm.nih.gov/books/NBK470567/ [accessed on Sep 19, 2019]
https://www.mayoclinic.org/tests-procedures/liver-biopsy/about/pac-20394576 [accessed on Sep 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (18)
Living with Hepatitis B
Video by Health Science Channel/YouTube
LIVER BIOPSY by Dr. Robert Gish
Video by Robert Gish/YouTube
Healthy liver (left) versus alcoholic liver disease (right)
Image by TheVisualMD
Gallbladder, Liver, and Pancreas
Gallbladder, Liver, and Pancreas
Image by Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Drawing of a liver biopsy procedure
Liver biopsy
Image by NIDDK Image Library
Drawing of a percutaneous liver biopsy, showing a liver within an outline of a male body, a needle pricking the liver tissue, and a slide with the tissue sample
Percutaneous liver biopsy is the most common type of liver biopsy.
Image by NIDDK Image Library
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
Liver biopsy
Image by NIDDK Image Library
Nonalcoholic Fatty Liver Disease (NAFLD)
A comparison of a healthy liver (top) and an unhealthy, fatty liver (bottom). The liver is a large organ, about the size of a football, located in the upper right abdomen underneath the ribs. It plays a major part in many core bodily functions such as metabolism, digestion, and detoxification. However, consuming excess calories, especially in the form of refined sugars, can cause fat to be stored in the liver--leading to a condition known as nonalcoholic fatty liver (NAFLD). The excess fat can lead to inflammation of the liver, which can become scarred and hardened.
Image by TheVisualMD
Alkaline Phosphatase (ALP): Liver
Many types of liver damage, including cancer and blocked bile ducts, can elevate ALP levels. Among the factors that raise an individual's risk of liver damage are: obesity, alcoholism, exposure to hepatitis viruses, and medications toxic to the liver.
Image by TheVisualMD
Bilirubin, Direct: Liver
If bilirubin is not being attached to sugars (conjugated) in the liver and/or is not being adequately removed from the blood, it can mean that there is damage to your liver. Testing for bilirubin in the blood is therefore a good test of damage to your liver.
Image by TheVisualMD
Liver Cross Section Hepatocytes and vascularization
Liver Cross Section Hepatocytes and vascularization
Image by TheVisualMD
Hepatocytes (Liver Cells)
Most of the cells in the liver (80%) are hepatocytes, which operate like microscopic chemical factories. The liver is responsible for removing toxins, converting and storing sugars and lipids, regulating metabolism, and manufacturing key enzymes, hormones, and proteins, including those involved in blood clotting, as well as producing bile, which aids digestion, and most of body's supply of cholesterol (the rest comes from food).
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Female Digestive System Including Liver
Female Digestive System Including Liver
Image by TheVisualMD
Bone, Kidney, Liver
Bone, Kidney, Liver
Image by TheVisualMD
Liver and Lipoproteins
Liver and Lipoproteins
Image by TheVisualMD
Enlarged Liver, a Sign of Hemochromatosis
Enlarged Liver, a Sign of Hemochromatosis : Hemochromatosis is a genetic disease that causes the body to absorb too much iron. Because the body can't use or eliminate this extra iron, it's stored in organs, especially the liver, but also the heart and pancreas. Eventually, up to 20 times as much iron as normal can accumulate, which can lead to organ failure. Symptoms can include irregular heartbeat, cirrhosis, chronic fatigue, confusion, and hepatomegaly, the enlargement of the liver.
Image by TheVisualMD
Liver Biopsy
Document by National Digestive Diseases Information Clearinghouse
Healthy Liver / Fatty Liver
Normal Liver vs Fatty Liver
In nonalcoholic fatty liver disease (NAFLD) fat accumulates in the liver cells. NAFLD is most often found in people who are middle-aged and overweight or obese. About half of all obese kids are also thought to have nonalcoholic fatty liver disease.
Interactive by TheVisualMD
3:51
Living with Hepatitis B
Health Science Channel/YouTube
6:55
LIVER BIOPSY by Dr. Robert Gish
Robert Gish/YouTube
Healthy liver (left) versus alcoholic liver disease (right)
TheVisualMD
Gallbladder, Liver, and Pancreas
Blausen.com staff (2014). \"Medical gallery of Blausen Medical 2014\". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436
Drawing of a liver biopsy procedure
NIDDK Image Library
Drawing of a percutaneous liver biopsy, showing a liver within an outline of a male body, a needle pricking the liver tissue, and a slide with the tissue sample
NIDDK Image Library
Drawing of a liver biopsy procedure and a slide with tissue sample, with the text- A small, slender core of tissue is removed with a biopsy needle and looked at through a microscope
NIDDK Image Library
Nonalcoholic Fatty Liver Disease (NAFLD)
TheVisualMD
Alkaline Phosphatase (ALP): Liver
TheVisualMD
Bilirubin, Direct: Liver
TheVisualMD
Liver Cross Section Hepatocytes and vascularization
TheVisualMD
Hepatocytes (Liver Cells)
TheVisualMD
Sensitive content
This media may include sensitive content
Female Digestive System Including Liver
TheVisualMD
Bone, Kidney, Liver
TheVisualMD
Liver and Lipoproteins
TheVisualMD
Enlarged Liver, a Sign of Hemochromatosis
TheVisualMD
Liver Biopsy
National Digestive Diseases Information Clearinghouse
Normal Liver vs Fatty Liver
TheVisualMD
Sentinel Lymph Node Biopsy
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
Sentinel Lymph Node Biopsy
Also called: SLNB, Biopsy of the Sentinel Lymph Node, Lymph Node Biopsy, Sentinel Node Biopsy, Sentinel Lymph Node Mapping and Biopsy
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Some cancers, such as breast cancer and melanoma, can spread through the lymphatic system. The sentinel lymph node is the first node where a cancer usually spreads. The test can show whether your cancer is likely to spread.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
Related conditions
Breast cancer
Melanoma
Penile cancer
Endometrial cancer
A sentinel lymph node biopsy is a test that checks lymph nodes for cancer cells. Lymph nodes are part of the lymphatic system, a network of organs and vessels that help the body fight infections and other diseases. Lymph nodes are located throughout the body, including the underarms, neck, chest, abdomen, and groin.
Certain cancers, such as breast cancer and melanoma (the most dangerous form of skin cancer), can spread through the lymphatic system. Cancers spread when cells break off from the original tumor and are carried to other parts of the body. The sentinel lymph node is the first node where these types of cancers are most likely to spread. The node is usually located near the site of the original tumor. Sometimes there is more than one sentinel lymph node.
A sentinel lymph node biopsy can show how likely it is that your cancer is spreading (metastasizing).
Other names: lymph node biopsy, sentinel node biopsy, sentinel lymph node mapping and biopsy
A sentinel lymph node biopsy is used to find out whether an early-stage cancer has spread through the lymphatic system. It's most often used for people who have breast cancer or melanoma.
You may need this test if you've been diagnosed with breast cancer, melanoma, or certain other types of cancer. It can show whether your cancer is spreading.
A sentinel lymph node biopsy may be done in a hospital or an outpatient surgical center. The procedure usually includes a special type of imaging test called lymphoscintigraphy. Lymphoscintigraphy takes pictures of the lymphatic system and is used to locate the sentinel lymph node. The procedure includes the following steps:
A health care provider will apply medicine to numb the skin over the procedure area.
You will be injected with a small amount of a radioactive substance called a tracer near the tumor. The tracer will travel and collect in the sentinel lymph node, or nodes. You may also be injected with a blue dye that stains the lymph node, making it easier to see.
You will be given general anesthesia. General anesthesia is a medicine that makes you unconscious. It makes sure you won't feel any pain during the surgery. A specially trained doctor called an anesthesiologist will give you this medicine.
Once you're unconscious, a camera will take images of the area. The camera finds and records the location of the tracer, which will have settled in the sentinel node.
The node will be removed and sent to a lab, where it will be checked for cancer cells. This part of the test is known as a biopsy.
The original tumor is also usually removed during the procedure.
You will probably need to fast (not eat or drink) for several hours before the test. You may also need to stop taking blood thinners, such as aspirin, for a certain time before your test. Your provider will let you know when you need to stop taking your medicine and anything else you need to do to prepare for the test.
In addition, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.
You may have a little bleeding, pain, or bruising at the biopsy site. There is also a small risk of infection, which can be treated with antibiotics. Allergic reactions to the tracer are rare and usually mild.
There is very little exposure to radiation in a sentinel lymph node biopsy. While radiation exposure from the tracer in a sentinel lymph node biopsy is safe for most adults, it can be harmful to an unborn baby. So be sure to tell your provider if you are pregnant or think you may be pregnant.
The results will be given as positive or negative.
If your results are positive, it means cancer was found and may have spread to nearby lymph nodes and/or other organs. Your provider may recommend removing and testing more lymph nodes to check for cancer cells.
If your results are negative, it means no cancer cells were found, and it's unlikely that the cancer has spread. You will not need to have any more lymph nodes removed.
If you have questions about your results, talk to your health care provider.
While sentinel lymph node biopsies are mostly used for people with breast cancer or melanoma, it is currently being studied for use with other types of cancer, including:
Colon cancer
Stomach cancer
Thyroid cancer
Non-small cell lung cancer
Sentinel Lymph Node Biopsy: MedlinePlus Medical Test [accessed on Feb 03, 2024]
Sentinel Lymph Node Biopsy - NCI. National Cancer Institute. Jun 25, 2019 [accessed on Feb 03, 2024]
Melanoma: Tests After Diagnosis - Health Encyclopedia - University of Rochester Medical Center [accessed on Feb 03, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
Sentinel Lymph Node & Axillary Lymph Node Procedures for Breast Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Surgery for Melanoma Patients: Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection
Video by American Cancer Society/YouTube
Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
Video by Breast Cancer School for Patients/YouTube
Sentinel Lymph Node Mapping for Gynecologic Cancers
Video by Memorial Sloan Kettering/YouTube
Introduction to the Lymphatic System
Video by Osmosis/YouTube
Lymphatic System, Part 2
Video by Tammy Moore/YouTube
The Lymphatic System, Part 1
Video by Tammy Moore/YouTube
The lymphatic system's role in immunity | Lymphatic system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
lymphatic system
Diagram of the lymphatic system.
Image by Cancer Research UK / Wikimedia Commons
Lymphatic System
Lymphatic System
Image by NIH
Lymph Node of Head and Neck
3D visualization reconstructed from scanned human data of male revealing lymphatic structures (lacrimal glands, tonsils, salivary glands, thymus, subclavian veins axillary nodes, stomach, cisterna chyli). The lymphatic system works in concert with the immune system. It can be described as an extensive network of vessels that shuttle molecular waste-filled fluid (lymph) through purifiying centers called lymph nodes.
Image by TheVisualMD
Lymphatic, circulatory and nervous systems
The systems of the human body consist of: circulatory, digestive, endocrine, immune/lymphatic, integumentary, muscular, reproductive, skeletal, urinary. This image depicts the circulatory, endocrine, immune/lymphatic, nervous
Image by TheVisualMD
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron needed for red blood cell production.
Image by TheVisualMD
Lymphatic System
Lymphatic Trunks and Ducts System
Image by OpenStax College
Babies Sitting Showing Respiratory Lymphatic Circulatory and Skeletal Systems
One of the most obvious ways that we notice the overall immune health of a baby is through the presence or absence of respiratory infections. Respiratory illness is the leading cause of hospitalization among young children. Lymph nodes and vessels are a direct component of the immune system. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, and thoracic regions. Lymph tissue aids the immune system by collecting and breaking down toxins and other waste products of the body. Lymph vessels transport lymph, a clear fluid derived from intercellular spaces around the body, eventually back into the blood. An infant's circulatory system will face an olympian job over the course of the individual's lifetime; the heart will beat 2.5 billion times and pump millions of gallons of blood through the body's vast network of arteries and veins. An infant's heart doubles in size the first year of life. Nutrition plays a key role in the development and maintenance of a healthy circulatory system by providing building blocks such as iron, needed for red blood cell production.
Image by TheVisualMD
In Defense of You: Your Immune System
Image by TheVisualMD
Lymph Node and Lymph interstitial fluid
Lymph Node and Vasculature: The image shows a human lymph node and its vasculature (blood vessels). Lymph nodes are encapsulated bundles of lymph tissue found throughout the body, especially in the neck, armpit, groin, lung, and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Lymph Node with Vasculature
Computer generated illustration of a human lymph node and its vasculature. Lymph nodes are encapsulated bundles of lymph tissue found throughout the body especially in the neck, axillae, groin, lung and aortic areas. These aggregations of lymph tissue aid the immunological system by collecting and breaking down toxins and other waste products of the body.
Image by TheVisualMD
Immune System and Autoimmune Diseases
Normally, an individual's immune system learns to identify and ignore all of the distinctive little structures found on that individual's own cells. Sometimes, however, it will make a mistake and identify its own body as foreign. If that happens, the immune system produces antibodies that attempt to destroy the body's own cells in the same way it would try to destroy a foreign invader.
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
Image by TheVisualMD
Sentinel Lymph Node Biopsy
This is a picture of the first radio-guided sentinel lymph node biopsy using real-time imaging by means of a portable gamma camera (Sentinella) in a patient with colon cancer
The lobes and ducts of the breast, and nearby lymph nodes (above) are areas that cancer can attack. The temporary inconvenience of a mammogram can save you from troublesome and costly treatment and surgery by catching breast cancer early, when it is easiest to treat.
Image by NIH
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Image by TheVisualMD
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Mastectomy (Simple)
Title Mastectomy (Simple) Description Treatment for breast cancer - removal of breast and a sample of underarm lymph nodes.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
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Radical Mastectomy
Mastectomy (Radical) Description Halsted radical mastectomy. Removal of the entire breast and chest muscles, as well as lymph nodes in underarm area for the treatment of breast cancer.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Front view of the breast
Diagram showing the front view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
Side view of the breast
Diagram showing the side view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
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Breast and adjacent lymph nodes
Illustration of Breast and Adjacent Lymph Nodes Description: The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute, Don Bliss (Illustrator)
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Breast and Adjacent Lymph Nodes
The female breast (nipple, areola, ducts, lobes, lobules, and fatty tissue) and adjacent lymph nodes and lymph vessels (no labels appear in the illustration).
Image by National Cancer Institute (NCI) / Don Bliss (Illustrator)
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Human Epidermal Growth Factor Receptor 2 (HER2): Aggressive Breast Cancers
Most breast cancers begin in the lobules or ducts of the breast, which produce breast milk and carry it to the nipples after pregnancy. Invasive cancers spread outside of the lobules and ducts and penetrate into the surrounding breast tissue. From there, cancer cells may travel to lymph nodes in the armpit area. In stage IV breast cancer, cancer cells have spread into other parts of the body, such as the lungs or bones. HER2-positive breast cancer is aggressive and is likely to spread quickly. It is also resistant to hormone therapy. However, treatment with the drugs trastuzumab and/or lapatinib may help women who test positive for HER2.
Image by TheVisualMD
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Metastatic Breast Cancer in Pleural Fluid
Image by Ed Uthman/Flickr
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Diagram showing the network of lymph nodes in and around the breast.
Diagram showing the network of lymph nodes in and around the breast.
Image by Cancer Research UK / Wikimedia Commons
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Breast lobes and ducts
Diagram showing the lobes and ducts of a breast.
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
Breast
Breast and Adjacent Lymph Nodes Description The female breast along with lymph nodes and vessels. An inset shows a close-up view of the breast with the following parts labeled: lobules, lobe, ducts, nipple, areola, and fat.
Image by National Cancer Institute
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Breast Anatomy
Breast Anatomy; observe lobes, lobules, ducts, areola, nipple, fat, lymph nodes and lymphatic vessels.
Image by National Cancer Institute / Don Bliss (Illustrator)
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External and Internal Anatomy of Breast
The breast is made up of a variety of tissues and structures, including fat, blood vessels, lymph vessels, ligaments, and nerves. The mammary gland is embedded in the breast's fatty tissue and contains 15-20 lobes, each of which is subdivided into smaller lobules. The breast milk that is produced drains from the lobes into the nipple via the lactiferous ducts.
Image by TheVisualMD
Lymph Nodes
Lymph Nodes
Lymph Nodes
Lymph Nodes
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Breast Lymph Nodes
Lymph vessels form a network in each breast, draining into lymph nodes in the underarm and along the breast bone. Cancer cells may break away from the main tumor and spread to other parts of the body through the lymphatic system.
Interactive by TheVisualMD
Sentinel Lymph Node Biopsy of the Breast
Sentinel lymph node biopsy of the breast. The first of three panels shows a radioactive substance and/or blue dye injected near the tumor; the middle panel shows that the injected material is followed visually and/or with a probe that detects radioactivity to find the sentinel nodes (the first lymph nodes to take up the material); the third panel shows the removal of the tumor and the sentinel nodes to check for cancer cells.
Sentinel lymph node biopsy of the breast. A radioactive substance and/or blue dye is injected near the tumor (first panel). The injected material is detected visually and/or with a probe that detects radioactivity (middle panel). The sentinel nodes (the first lymph nodes to take up the material) are removed and checked for cancer cells (last panel).
A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.
Skin Biopsy
Also called: Skin Lesion Biopsy
A skin biopsy is a procedure that removes a small sample of skin for testing. Skin biopsies are used to check for skin cancer, skin infections, or skin disorders, such as psoriasis.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
If your results are normal, it means no cancer or skin disease was found. If a skin lesion is benign (not cancer), you may not need any further treatment.
Related conditions
A skin biopsy is a procedure that removes a small sample of skin for testing. The procedure can help diagnose a skin lesion (an abnormal area of skin). The skin sample is looked at under a microscope to check for skin cancer, a variety of skin conditions, or skin infections. Only certain skin lesions need a biopsy. Your provider may be able to diagnose many types of lesions just by looking at them.
There are three main ways to do a skin biopsy. The type of biopsy you have depends on the location, size, and depth of the skin lesion:
A shave biopsy removes a sample from the top layers of skin with a razor blade or scalpel (a small cutting blade used for surgery). Your provider will do a shave biopsy if your condition appears to involve only the top layers of skin.
A punch biopsy uses a special tool with a round blade to remove the skin sample. Your provider will do a punch biopsy if your condition appears to involve the deep layers of skin.
An excisional biopsy uses a scalpel to remove all of the skin lesion, usually with some normal skin around it. The sample may include the full thickness of the skin along with fat below the skin.
Most skin biopsies can be done in a health care provider's office or other outpatient facility.
A skin biopsy is used to help diagnose a variety of skin conditions including:
Skin disorders such as psoriasis, eczema, actinic keratosis ("precancers"), and warts.
Bacterial or fungal infections of the skin.
Skin cancer. A biopsy can confirm or rule out whether a suspicious mole or other growth is cancer. If the result is cancer, the biopsy can show what type of skin cancer it is.
Skin cancer is the most common type of cancer in the United States. The two most common types of skin cancer are basal cell and squamous cell cancers. These cancers rarely spread to other parts of the body and can usually be cured with treatment. In many cases, the biopsy removes all the cancer, and no other treatment is needed.
The most serious type of skin cancer is melanoma. It's more likely than other skin cancers to spread to other parts of your body, including to your organs. Most deaths from skin cancer are caused by melanoma.
A skin biopsy can help diagnose skin cancer in the early stages, when it's easier to treat.
You may need a skin biopsy if you have certain skin symptoms, such as:
A rash that doesn't go away
Scaly or rough skin
Open sores that won't heal
A mole or skin growth that has changed in its shape, color, or size
A mole or new growth that has the "A-B-C-D-Es" of melanoma:
Asymmetrical - the shape is not regular
Border - the edge is jagged
Color - the color is uneven
Diameter - the size is larger than a pea
Evolving - the mole or growth has changed in the past few weeks or months
Blistering skin, which may be a sign of pemphigus, an autoimmune disease
A provider will clean the site and give you an injection (shot) to numb your skin so you won't feel any pain.
For a punch biopsy:
A provider uses a special tool with a hollow, round blade. The blade is placed over the abnormal skin area (lesion) and rotated to remove a small piece of skin about the size of a pencil eraser.
The sample is lifted out with another tool.
If a larger skin sample is taken, you may need one or two stitches to close the wound.
Pressure will be applied to the wound until the bleeding stops.
The wound will be covered with a bandage.
A punch biopsy is often used to diagnose rashes.
For a shave biopsy:
A provider will use a razor or a scalpel to remove a sample from the top layer of your skin.
To help stop the bleeding, pressure will be applied to the wound, or medicine may be spread over the wound.
The wound will be covered with a bandage.
A shave biopsy is often used if your provider thinks you may have basal cell or squamous cell skin cancer or if you have a rash appears to affect only the top layer of your skin.
For an excisional biopsy:
A doctor will use a scalpel to remove the entire skin lesion, usually with some normal skin around it called "a margin." If the skin lesion is large, your provider may remove only a piece of it. This is called an incisional biopsy.
The doctor will close the wound with stitches.
Pressure will be applied to wound until the bleeding stops.
The wound will be covered with a bandage.
An excisional biopsy is often used if your provider thinks you may have melanoma, the most serious type of skin cancer. It may also be used for basal cell and squamous cell skin cancer.
After the biopsy, keep the area covered with a bandage until you've healed or until your stitches come out. If you had stitches, they will be taken out 3-14 days after the biopsy.
You don't need any special preparations for a skin biopsy.
You may have a little bruising, bleeding, or soreness at the biopsy site. If these symptoms last longer than a few days or they get worse, tell your provider.
Infection is possible, so it's important to keep the wound clean until it heals. Your provider will tell you how to care for your wound. You may have a scar after healing.
A normal biopsy result means no cancer or skin disease was found.
An abnormal biopsy result may diagnose a specific skin condition. But sometimes abnormal results aren't clear, and you may need more tests to find out exactly what condition you have. Your provider can explain what your results mean.
If your provider thinks you may have a basal cell or squamous cell cancer, the entire lesion may be removed during the biopsy. Often, the biopsy removes the entire cancer and no other treatment is needed.
If you are diagnosed with melanoma, you will need more tests to see if the cancer has spread. Then you and your health care provider can develop a treatment plan that's right for you.
Skin Biopsy: MedlinePlus Lab Test Information [accessed on Oct 05, 2022]
Skin lesion biopsy: MedlinePlus Medical Encyclopedia [accessed on Dec 20, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Punch Biopsy
Empty pilar cyst removed from the scalp of a woman through a small punch biopsy hole through the scalp.
Image by Northerncedar (talk)
Hyperkeratosis
Low magnification micrograph of lichen simplex chronicus. Skin biopsy.
Image by Nephron
Lichen simplex chronicus
Very low magnification micrograph of lichen simplex chronicus, abbreviated LSC. H&E stain. Skin biopsy.Features:
Image by Nephron
Stevens-Johnson syndrome
Very high magnification micrograph of confluent epidermal necrosis. Skin biopsy. H&E stain.
Image by Nephron
Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.
Image by CDC/ Dr. Peter Drotman
Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
Kaposi sarcoma, is a malignant tumor of the lymphatic endothelium caused by the Human herpesvirus 8 (HHV8), i.e., Kaposi’s sarcoma-associated herpesvirus (KSHV), and arises from a cancer of the lymphatic endotheial lining. It is characterized by bluish-red cutaneous nodules. Kaposi’s sarcoma is thought of as an opportunistic infection, affecting patients whose immune systems have been compromised, as in the case of patients with HIV/AIDS.
Image by CDC/Dr. Peter Drotman
This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.
The dermis contains a dense cellular infiltrate, and narrow slit-like vascular spaces that are characteristic in these KS lesions. KS is a cancer that is common in those who’ve developed the human immunodeficiency virus (HIV), or an AIDS infection.
Image by CDC/ Dr. Steve Kraus
Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.
Note the thinning of the skin layers, most appreciably the dermis, which is reduced in thickness, and flattened due to the presence of a cellular subdermal infiltrate.
Image by CDC/ Dr. Steve Kraus
An illustration depicting the skin punch biopsy.
An illustration depicting the skin punch biopsy.
Image by BruceBlaus
Having a punch biopsy
Video by University Hospitals Birmingham NHS Foundation Trust/YouTube
Biopsy - What You Need To Know
Video by Rehealthify/YouTube
Study examines accuracy of melanoma biopsy findings
Video by UW Medicine/YouTube
What happens to your biopsy?
Video by Sunnybrook Hospital/YouTube
Skin Biopsy for Skin Cancer
Video by Dermatology Office of Dr. Ellen Turner/YouTube
Punch Biopsy
Northerncedar (talk)
Hyperkeratosis
Nephron
Lichen simplex chronicus
Nephron
Stevens-Johnson syndrome
Nephron
Under a medium magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the appearance of the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
CDC/ Dr. Peter Drotman
Under a low magnification, this photomicrograph depicts the histopathologic changes seen in human skin biopsy specimen due to Kaposi’s sarcoma. Of importance is the normal appearance of the most superficial epidermal layer on the far left, which was overlying the dermal layer, which contained a cellular infiltrate, and a proliferation of vascular elements.
CDC/Dr. Peter Drotman
This photomicrograph of a skin biopsy reveals some cytoarchitectural signs that are indicative of Kaposi's sarcoma.
CDC/ Dr. Steve Kraus
Under medium magnification, this micrograph of a skin biopsy shows the cytoarchitectural changes found in Kaposi's sarcoma.
CDC/ Dr. Steve Kraus
An illustration depicting the skin punch biopsy.
BruceBlaus
1:36
Having a punch biopsy
University Hospitals Birmingham NHS Foundation Trust/YouTube
0:47
Biopsy - What You Need To Know
Rehealthify/YouTube
3:13
Study examines accuracy of melanoma biopsy findings
UW Medicine/YouTube
3:26
What happens to your biopsy?
Sunnybrook Hospital/YouTube
0:26
Skin Biopsy for Skin Cancer
Dermatology Office of Dr. Ellen Turner/YouTube
Testicular Biopsy
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
Testicular Biopsy
Also called: Biopsy of the Testicle
A testicular biopsy is a procedure in which a small tissue sample from one or both testicles is taken and then sent to a specialist for its evaluation. This test can be used to help find the cause of male infertility or to diagnose testicular cancer.
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Your result is Normal.
A normal biopsy result means that no cancer or abnormal cells were found and sperm development appears to be normal.
Related conditions
A testicular biopsy is a test in which a small piece of tissue from one or both testicles is taken and then sent to a pathologist for evaluation.
Your doctor may want to order this test to help find the cause of male infertility in the following situations:
When a semen analysis shows abnormalities in the sperm and other tests (such as blood and hormone tests) have not found the cause
To distinguish between obstructive and nonobstructive causes of azoospermia (absence of sperm)
To retrieve sperm for in vitro fertilization (IVF)
A testicular biopsy may also be done if an abnormal mass has been found during testicular examination. In this case, the biopsy is more frequently performed intraoperatively (during the surgery) to determine whether the mass is cancerous or noncancerous. If cancer is found, the entire testicle is removed (orchidectomy).
There are several approaches to take the testicular tissue sample, which are by performing an open biopsy (doing a small incision in the testicle) or a percutaneous biopsy (inserting a thin biopsy needle through the scrotum).
The kind of biopsy you have depends on the reason for the test.
Open Biopsy
For the open biopsy you will be put under local or general anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor makes a small cut in the skin and testicle. Then a small sample of the testicle tissue is removed, and stitches are used to close both cuts.
Percutaneous Biopsy
For the percutaneous biopsy you will be put under local anesthesia, then the scrotum is cleaned with a germ-killing (antiseptic) solution, and your doctor will insert a thin biopsy needle into the testicle. Then a small sample of the testicle tissue is aspirated. This procedure does not require an incision or stitches.
No special preparations are usually necessary. Inform your healthcare practitioner if you are taking any over-the-counter or prescription medications.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, hematomas, and infection. You may also present a bad reaction to the anesthesia.
After the biopsy is common for the area to be sore, this usually goes away within two or three days.
You may also be required to avoid any sexual activity for one or two weeks after the test.
A testicular biopsy is normal when no cancerous cells are found, and sperm development appears to be normal.
Results are considered abnormal when any of the following findings are present:
Spermatocele (a lump filled with fluid and dead sperm cells)
Orchitis (inflammation of the testicles, usually caused by an infection)
Testicular cancer
If your testicular biopsy result is normal, but your semen analysis shows azoospermia (absence of sperm) or oligozoospermia (low sperm count), this may indicate a blockage of the vans deferens (the tube through which the sperm passes from the testes to the urethra). Blockages can usually be repaired with surgery.
DIAGNOSTIC PROCEDURES | Stony Brook Medicine [accessed on Dec 27, 2018]
Testicular biopsy Information | Mount Sinai - New York [accessed on Dec 27, 2018]
Testicular biopsy and vasography in the evaluation of male infertility. - PubMed - NCBI [accessed on Dec 27, 2018]
https://www.researchgate.net/publication/265934322_Diagnostic_Surgery_Vasography_Seminal_Vesicle_Aspiration_and_Testis_Biopsy [accessed on Dec 27, 2018]
Testicle Biopsy: Purpose, Procedure & Recovery [accessed on Dec 27, 2018]
Testicular biopsy: clinical practice and interpretation [accessed on Dec 27, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Thyroid Biopsy
Thyroid Biopsy
Also called: Thyroid Fine Needle Biopsy, Thyroid Fine Needle Aspiration Biopsy, Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid
This test tells whether thyroid nodules have normal cells in them. Your doctor may numb an area on your neck. Your doctor will then stick a very thin needle into the thyroid to take out some cells and fluid. A doctor will then look at the cells under a microscope to see if they are normal. Cells that are not normal could mean thyroid cancer.
Thyroid Biopsy
Also called: Thyroid Fine Needle Biopsy, Thyroid Fine Needle Aspiration Biopsy, Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid
This test tells whether thyroid nodules have normal cells in them. Your doctor may numb an area on your neck. Your doctor will then stick a very thin needle into the thyroid to take out some cells and fluid. A doctor will then look at the cells under a microscope to see if they are normal. Cells that are not normal could mean thyroid cancer.
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Your result is Benign.
Benign – This accounts for up to 70% of biopsies when using the Bethesda System (one of the most common ways that cytopathologists classify nodule biopsy specimens). The risk of malignancy in this group is typically less than 3%. These nodules are generally monitored with a follow up ultrasound within 18 months and if needed, periodically after that.
Related conditions
Thyroid Tests | NIDDK [accessed on May 09, 2022]
https://www.womenshealth.gov/a-z-topics/thyroid-disease [accessed on May 09, 2022]
https://www.thyroid.org/fna-thyroid-nodules/ [accessed on May 09, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Systems That Describe Stage
T1 - the tumor is 2 cm across or less.
T2 - the tumor is more than 2 cm but no more than 5 cm across.
T3 - the tumor is bigger than 5 cm across.
Stage 3B breast cancer - Diagram 1 of 2
3D medical animation still showing metastatic or stage 4 Breast Cancer
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TNM Staging for Breast Cancer
Interactive by Cancer Research UK
T1 - the tumor is 2 cm across or less.
T2 - the tumor is more than 2 cm but no more than 5 cm across.
T3 - the tumor is bigger than 5 cm across.
Stage 3B breast cancer - Diagram 1 of 2
3D medical animation still showing metastatic or stage 4 Breast Cancer
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TNM Staging for Breast Cancer
The breast cancer TNM staging system is the most common way that doctors stage breast cancer. TNM stands for Tumor, Node, Metastasis. Your scans and tests give some information about the stage of your cancer. But your doctor might not be able to tell you the exact stage until you have surgery.
Interactive by Cancer Research UK
Systems That Describe Stage
There are many staging systems. Some, such as the TNM staging system, are used for many types of cancer. Others are specific to a particular type of cancer. Most staging systems include information about:
Where the tumor is located in the body
The cell type (such as, adenocarcinoma or squamous cell carcinoma)
The size of the tumor
Whether the cancer has spread to nearby lymph nodes
Whether the cancer has spread to a different part of the body
Tumor grade, which refers to how abnormal the cancer cells look and how likely the tumor is to grow and spread
The TNM Staging System
The TNM system is the most widely used cancer staging system. Most hospitals and medical centers use the TNM system as their main method for cancer reporting. You are likely to see your cancer described by this staging system in your pathology report, unless you have a cancer for which a different staging system is used. Examples of cancers with different staging systems include brain and spinal cord tumors and blood cancers.
In the TNM system:
The T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor.
The N refers to the the number of nearby lymph nodes that have cancer.
The M refers to whether the cancer has metastasized. This means that the cancer has spread from the primary tumor to other parts of the body.
When your cancer is described by the TNM system, there will be numbers after each letter that give more details about the cancer—for example, T1N0MX or T3N1M0. The following explains what the letters and numbers mean:
Primary tumor (T)
TX: Main tumor cannot be measured.
T0: Main tumor cannot be found.
T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b.
Regional lymph nodes (N)
NX: Cancer in nearby lymph nodes cannot be measured.
N0: There is no cancer in nearby lymph nodes.
N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
Distant metastasis (M)
MX: Metastasis cannot be measured.
M0: Cancer has not spread to other parts of the body.
M1: Cancer has spread to other parts of the body.
Other Ways to Describe Stage
The TNM system helps describe cancer in great detail. But, for many cancers, the TNM combinations are grouped into five less-detailed stages. When talking about your cancer, your doctor or nurse may describe it as one of these stages:
Stage
What it means
Stage 0
Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer.
Stage I, Stage II, and Stage III
Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.
Stage IV
The cancer has spread to distant parts of the body.
Another staging system that is used for all types of cancer groups the cancer into one of five main categories. This staging system is more often used by cancer registries than by doctors. But, you may still hear your doctor or nurse describe your cancer in one of the following ways:
In situ—Abnormal cells are present but have not spread to nearby tissue.
Localized—Cancer is limited to the place where it started, with no sign that it has spread.
Regional—Cancer has spread to nearby lymph nodes, tissues, or organs.
Distant—Cancer has spread to distant parts of the body.
Unknown—There is not enough information to figure out the stage.
Source: National Cancer Institute (NCI)
Additional Materials (5)
T1 stage - the tumor is inside the pancreas and is 2cm or less in any direction.
T2 stage - the cancer is more than 2cm but no more than 4cm in size in any direction.
T3 stage - the cancer is more than 4cm in size.
T4 stage - the cancer has grown outside the pancreas, into the nearby large blood vessels.
Node (N) describes whether the cancer has spread to the lymph nodes. It is further divided into N0 and N1 stages.
Metastasis (M) describes whether the cancer has spread to a different part of the body. It is further divided into M0 and M1 stages.
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TNM Staging for Pancreatic Cancer
TNM stands for Tumour, Node, Metastasis. This system describes the size of a primary tumour (T), whether there are lymph nodes with cancer cells in them (N) and whether the cancer has spread to a different part of the body (M).
Interactive by Cancer Research UK
Staging cancers: TNM and I-IV systems
Video by Oncology for Medical Students/YouTube
Stage 1: Cancer is confined to a small area of the prostate.
Stage 2: Cancer is confined to the prostate but has spread within it, patient had a high Gleason score, had a high PSA level, or can be felt.
Stage 3: Cancer has spread outside the prostate and may have spread to the seminal vesicles, but has not spread anywhere else.
Stage 4: Cancer has spread to nearby tissues (other than the seminal vesicles), or to the lymph nodes, or to distant sites in the body.
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Prostate Cancer Summary Staging
Cancer staging helps in estimating the patient's prognosis and in deciding on treatment. If tests show the cancer is likely to have spread, imaging and other tests are done to see the extent of the cancer and to assign it a stage.
Interactive by TheVisualMD
Stage 0a and 0is
Stage 1
Stage 2
Stage 3A
Stage 3B
Stage IVA and IVB
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Bladder Cancer Staging (AJCC 8th Edition)
A staging system is a standard way for the cancer care team to describe how far a cancer has spread. The staging system most often used for bladder cancer is the American Joint Committee on Cancer (AJCC) TNM system.
Learning that you have cancer can be a shock and you may feel overwhelmed at first. When you meet with your doctor, you will hear a lot of information. These questions may help you learn more about your cancer and what you can expect next.
What type of cancer do I have?
What is the stage of my cancer?
Has it spread to other areas of my body?
Will I need more tests before treatment begins? Which ones?
Which types of doctors do I need to see for my cancer treatment?
Will you help me find a doctor to give me another opinion on the best treatment plan for me?
How serious is my cancer?
What are my chances of survival?
Source: National Cancer Institute (NCI)
Additional Materials (9)
Man and woman couple with doctor or therapist
Image by NIMH Image Library
Cancer Basics – Coping when you’re first diagnosed with cancer
Video by Canadian Cancer Society/YouTube
Cancer Diagnosis: What to Ask
Video by Cancer Treatment Centers of America - CTCA/YouTube
Questions You Should Ask After Receiving a Cancer Diagnosis -- The Doctors
Video by The Doctors/YouTube
3 Questions to Ask Your Oncologist After Being Diagnosed With Cancer
Video by Cancer.Net/YouTube
A Breast Cancer Diagnosis: Now What?
Video by Swedish/YouTube
Colon cancer staging
Colon cancer staging : After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Man and woman couple with doctor or therapist
NIMH Image Library
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Cancer Basics – Coping when you’re first diagnosed with cancer
Canadian Cancer Society/YouTube
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Cancer Diagnosis: What to Ask
Cancer Treatment Centers of America - CTCA/YouTube
4:45
Questions You Should Ask After Receiving a Cancer Diagnosis -- The Doctors
The Doctors/YouTube
1:06
3 Questions to Ask Your Oncologist After Being Diagnosed With Cancer
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Cancer Staging
Staging is the process of determining how much cancer is within the body (tumor size) and if it has spread. To learn the stage of the disease, doctors may order x-rays, lab tests, and other tests or procedures. Learn about the TNM Staging system and other ways that stage is described.