Bone Marrow (Trephine Biopsy) Tips

A procedure done to remove a piece of tissue from your body so that it can be analyzed in a laboratory is termed as 'biopsy'.

A biopsy is done to determine whether you have cancer or some other condition. They help to differentiate cancerous cells from noncancerous cells.

It is performed by a surgeon, interventional radiologist, or an interventional cardiologist.

Types of biopsy procedures

1. Bone Marrow biopsy.
2. Bone marrow is the spongy material inside some of your larger bones where blood cells are produced.
3. This biopsy is done if the doctor suspects cancer to have originated in or travelled to your bone marrow.
4. Bone marrow biopsy is done to diagnose leukemia, lymphoma and multiple myeloma.
5. A bone marrow biopsy detects cancers that started elsewhere and traveled to the bone marrow.

Endoscopic biopsy

1. During endoscopy, your doctor uses a thin, flexible tube (endoscope) with a light on the end to see structures inside your body. It has a close-focusing telescope on the end for viewing.
2. To analyze cells of a tissue, special tools are passed through the tube.
3. Tubes are inserted through your mouth, rectum, urinary tract or a small incision in your skin.
4. Examples: Cystoscopy to collect tissue from inside your bladder, bronchoscopy to get tissue from inside your lung and colonoscopy to collect tissue from inside your colon.

Needle biopsy

1. During a needle biopsy, the doctor uses a special needle to extract cells from a suspicious area.
2. A needle biopsy is often used on tumors that the doctor can feel through your skin, such as suspicious breast lumps and enlarged lymph nodes.

Needle biopsy procedures include:

1. Fine-needle aspiration
2. Core needle biopsy
3. Vacuum-assisted biopsy

Skin biopsy
A skin (cutaneous) biopsy removes cells from the surface of your body. A skin biopsy is used to diagnose skin conditions, including melanoma and other cancers. The type of skin biopsy to be done depends on the type of cancer suspected.

Skin biopsy procedures include:

1. Shave biopsy- The doctor uses a tool similar to a razor to scrape the surface of your skin.
2. Punch biopsy- The doctor uses a circular tool to remove a small section of your skin's deeper layers.
3. Incisional biopsy- The doctor uses a scalpel to remove a small area of skin.
4. Excisional biopsy- The doctor removes an entire lump

You receive a local anesthetic to numb the biopsy site before the procedure.

Biopsy analysis and results
A biopsy guides the doctor to determine cancer's grade. The grade is sometimes expressed as a number on a scale of 1 to 4 and is determined by how cancer cells look under the microscope.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Oralcdx (oralcdx laboratories, inc. Suffern, ny), the oral brush biopsy with computer aided analysis, is a diagnostic tool that identifies dysplasia in common oral spots that often have no suspicious clinical features. In comparison to exfoliative cytology, the brush biopsy technique collects cells from the full thickness of the oral epithelium. An oral brush biopsy is a chair-side, painless, easy to perform a test that can be used to identify any suspicious lesion including common small white and red oral lesions to rule out dysplastic features. Since most oral lesions are benign in nature, most test results are likely to be benign. Almost 10% of all cases usually turn out to be abnormal. Based on the results, the laboratory advises specific guidance on these abnormal cases sometimes recommending scalpel biopsy, observation or retesting.

An early detection of cancer increases the chance of cure and survival; the same is true in the case of breast cancer as well. However, globally, an estimated 80% of women that undergo breast biopsy for diagnosis do not have breast cancer. So, when should a woman undergo breast biopsy? Read on to get an in-depth understanding.

What is a breast biopsy?
A breast biopsy is a clinical test that detects unhealthy tissues and suspicious fluids in the human breast. The sick cells are removed and examined under a microscope in a bid to detect breast cancer. A biopsy is the only means of determining whether the suspect area in the breast is affected by cancer.

What are the types of breast biopsy?
Various types of breast biopsy procedures are practised. These include fine-needle aspiration biopsy, core needle biopsy, stereotactic biopsy, ultrasound-guided core needle biopsy, MRI-guided core needle biopsy, and surgical biopsy.

The fine-needle aspiration biopsy is the most uncomplicated process that can evaluate a lump which can be felt during a clinical exam. Core needle biopsy may be used for evaluating lumps that are visible on a mammogram or ultrasound scanning. Stereotactic biopsy utilizes mammograms to pinpoint a location of suspicion within the breast.

Ultrasound-guided and MRI-guided core needle biopsy methods are used to guide core needle biopsy processes.

When is it recommended?
A gynaecologist may recommend undergoing a breast biopsy if he or she suspects a lump or thickening of the flesh in the breast. Mammograms and ultrasound or MRI techniques may detect a suspicious finding. Subsequently, patients have to undergo a breast biopsy to confirm the presence (or absence) of cancerous growth in the breast. Doctors and health professionals also recommend the test if conditions such as unusual areolar or nipple changes (such as scaling, crusting, bloody discharge or dimpled skin) are detected.

What are the preparations involved?
Before undergoing the breast biopsy, patients should inform their doctors about any allergies or any consumption of prescribed medication such as aspirin or other blood-thinning tablets. Similarly, doctors must be notified in advance if patients are unable to lie on their stomach for a long stretch of time. When biopsy procedures involve magnetic resonance imaging, doctors must be told if the patient has a cardiac pacemaker or any other electronic device implanted in their body. Also, health professionals must be advised when biopsy candidates are pregnant. These precautions are necessary because an MRI biopsy may not be suitable in these circumstances.

Women that are scheduled to undergo biopsy must wear an excellent supporting brassiere since they may have to hold a cold pack in the biopsy site. The correct undergarment can hold the pack in place and offers the necessary support.

It is worthy to note that multiple breast biopsy procedures may be required to obtain a tissue sample from the patient’s breast. The attending gynaecologist may recommend a particular method based on the size, location, and other individual characteristics of a lump in the breast.

So, you might have to undergo the procedure if recommended by your doctor. Patients can seek a second opinion if skeptical in this regard.

A tumor may be defined as an abnormal unwanted growth of tissue in any part of the body. This word need not immediately cause panic because the tumor may or may not cause a health threat. There are three types of tumors:

1. Benign tumor: This is a noncancerous type of tumor. In our body, new cells are formed while the old ones called dead ones are disposed by our immune system. When this disposal of cells does not occur, the remaining dead cells form a lump, which is called a benign tumor. They are not dangerous since, they do not contain harmful fluids and do not spread. A person suffering from a benign tumor in the brain may have frequent headaches.
2. Pre-malignant tumor: It is an initial disorder, or an earlier symptom of cancer manifestation. The inclination of this medical condition is that it will progressively become precarious. This is so because it is capable of conquering neighboring tissues and spreading as well. Leukoplakia is a form of premalignant cancer. They evolve as thick white patches inside the cheeks or on gums below the tongue. These patches are very difficult to be scraped off from the mouth. They are caused mainly due to chewing tobacco and smoking, and ff left untreated can expand.
3. Malignant tumor: These are the cancerous tumors, in which cells multiply abnormally and rapidly. They are unstable and travel along bloodstream, circulatory system and lymphatic system to other parts of the body. Sarcomas and carcinomas are the most common types of malignant tumors. While the former is related to connective tissues the latter is related to organs and glands.

The most common procedure to name the type of cancer is to refer to their site of origin. Adenocarcinoma, refers to cancer in the adenoid glands. Similarly, a benign tumor of fatty tissue is called lipoma, where as a malignant tumor in the same area is referred to as liposarcoma.

What is a biopsy? How does it relate to a tumor?
A Biopsy is a medical procedure practised by qualified medical practitioners. This procedure helps in identifying the type of tumor within a patient. It aids the doctor to conclude the type of treatment to be given to any patient. This procedure is a definite diagnosis to the identification of cancer. A Biopsy is the removal of a sample of the abnormal, unwanted tissue for laboratory examination. Biopsies are of different types, and they may be performed using ultrasound, CT scan or MRI depending on where the tumor is.

1. Excisional biopsy: In this method the entire lump of excess tissue is removed.
2. Incisional biopsy: Here a sample of the abnormal tissue is removed surgically.
3. Needle aspiration biopsy: Here the sample is extracted with the help of a needle.

After extraction, the tissue layers are sent to pathological departments to check their composition, and cause of disease.

In case you have a concern or query you can always consult an expert & get answers to your questions!

A kidney biopsy is a procedure where the doctor extracts a piece of kidney tissue and examines it to look for signs of damage and disease.

Why is a kidney biopsy done?

Usually, doctors prescribe kidney biopsy if they suspect you have a kidney problem, to determine how severe your kidney disease is or to monitor kidney treatment.  A few other reasons why a kidney biopsy is done are –

• If you have blood in the urine
• Excessive protein discharge in the urine
• If waste products start accumulating in the blood due to impaired kidney function

How do you prepare for a kidney biopsy?

Before you undergo the procedure, you will be asked to provide a urine and a blood sample to rule out the presence of infections. You also have to stop drinking and eating eight hours prior to the surgery.

Moreover, you need to tell the doctor if you are taking medications. The doctor may ask you to stop taking medications like ibuprofen and blood-thinning medications as they can increase the risk of blood loss during the procedure.

During the procedure

First, the doctor identifies the area where the needle will be inserted. This is done with an ultrasound or a CT scan. Once the area is identified, a local anaesthetic is applied.

After this, a small incision is made and the needle is inserted in the body and guided towards the kidney. The doctor will ask you to hold your breath while the sample is collected using a spring instrument.

If the tissue collected is inadequate in the first attempt, the doctor may insert the needle multiple times to collect sufficient tissue. Once sufficient tissue is collected, the needle is removed and a bandage is applied to the area.

Post-procedure

Once the procedure is complete, you will be taken to the recovery room where your essentials (blood pressure and heartbeat) will be monitored.

You may experience pain at the incision site for which you will be given medications. Usually, you will be allowed to leave on the same day as the surgery.

Consult a doctor if the pain aggravates, you have a fever or you notice blood in urine 24 hours after the procedure.

Once you have the results from your biopsy, you may need to visit the doctor for a follow-up.

Kidneys play an important metabolic role and are essential for balancing salt, minerals and water in the body. They also play a significant role in removing waste products from the body. They make urine, which contains all the waste materials that are eliminated from the body. They also play an important role in blood pressure regulation and in maintaining the balance of various minerals in the body. Any suspected kidney damage should be confirmed by a kidney biopsy, which will reveal the exact disease, thereby directing towards the appropriate treatment. 

Why and when is it done? 

A renal or kidney biopsy is done in the following situations: 

1. When there is abnormal protein in the blood or urine, which is indicative of a kidney disease, and the exact cause needs to be found out
2. When kidney failure is suggested by blood tests but cause is not clear 
3. To find the cause of bleeding in the urine (haematuria) 
4. To identify and/or confirm diagnosis after a CT scan or ultrasound 
5. To check how well a transplanted kidney has been received 

Know about the procedure 

A renal biopsy is mostly done as an outpatient procedure and is a type of biopsy known as percutaneous biopsy (biopsy where a needle is inserted through the skin into the renal tissue). Very rarely, it may be combined with the CT scan or ultrasound and be done in the radiology department. This may be done on inpatients. The patient is made to lie on his/her back and a local anesthetic is used on the area of the injection. A thin, long needle is directed towards the area of the kidney from where some kidney tissue is removed for sampling.

In some cases, the direction of the needle may be decided by a CT scan or ultrasound. While this is a closed biopsy procedure, in some cases, as a part of the surgery, open biopsies may also be obtained, where a sample of tissue is extracted for analysis. 

Recovering from a biopsy 
The person would need some time to recover from the procedure, as there would be some discomfort at the site of a needle insertion. Vital signs would be monitored for the next couple of hours during which the person would also be monitored for internal bleeding. A pain reliever can be used if required. Haematuria or blood-tinged urine can be seen disappearing within the next 12 hours. Very rarely the bleeding can be severe and require angiography and further procedures. The person should also avoid strenuous activities for the next few days.

Early detection of cancer increases the chance of cure and survival; the same is true in the case of breast cancer as well. However, globally, an estimated 80% of women that undergo breast biopsy for diagnosis do not have breast cancer. So, when should a woman undergo breast biopsy? Read on to get an in-depth understanding.

What is a breast biopsy?
A breast biopsy is a clinical test that detects unhealthy tissues and suspicious fluids in the human breast. The sick cells are removed and examined under a microscope in a bid to detect breast cancer. A biopsy is the only means of determining whether the suspect area in the breast is affected by cancer.

What are the types of breast biopsy?
Various types of breast biopsy procedures are practised. These include fine-needle aspiration biopsy, core needle biopsy, stereotactic biopsy, ultrasound-guided core needle biopsy, MRI-guided core needle biopsy, and surgical biopsy.

The fine-needle aspiration biopsy is the most uncomplicated process that can evaluate a lump which can be felt during a clinical exam. Core needle biopsy may be used for evaluating lumps that are visible on a mammogram or ultrasound scanning. Stereotactic biopsy utilizes mammograms to pinpoint a location of suspicion within the breast.

Ultrasound-guided and MRI-guided core needle biopsy methods are used to guide core needle biopsy processes.

When is it recommended?
A gynaecologist may recommend undergoing a breast biopsy if he or she suspects a lump or thickening of the flesh in the breast. Mammograms and ultrasound or MRI techniques may detect a suspicious finding. Subsequently, patients have to undergo a breast biopsy to confirm the presence (or absence) of cancerous growth in the breast. Doctors and health professionals also recommend the test if conditions such as unusual areolar or nipple changes (such as scaling, crusting, bloody discharge or dimpled skin) are detected.

What are the preparations involved?
Before undergoing the breast biopsy, patients should inform their doctors about any allergies or any consumption of prescribed medication such as aspirin or other blood-thinning tablets. Similarly, doctors must be notified in advance if patients are unable to lie on their stomach for a long stretch of time. When biopsy procedures involve magnetic resonance imaging, doctors must be told if the patient has a cardiac pacemaker or any other electronic device implanted in their body. Also, health professionals must be advised when biopsy candidates are pregnant. These precautions are necessary because an MRI biopsy may not be suitable in these circumstances.

Women that are scheduled to undergo biopsy must wear an excellent supporting brassiere since they may have to hold a cold pack in the biopsy site. The correct undergarment can hold the pack in place and offers the necessary support.

It is worthy to note that multiple breast biopsy procedures may be required to obtain a tissue sample from the patient’s breast. The attending gynaecologist may recommend a particular method based on the size, location, and other individual characteristics of a lump in the breast.

So, you might have to undergo the procedure if recommended by your doctor. Patients can seek a second opinion if sceptical in this regard.

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it.

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce the chances of the biopsy by 30% to 50% is by the 4K test. It helps to detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it.

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically.

As cancer prostate is treatable so no need to panic. Depending on the stage the treatment is offered, which can be Robotic surgery, radiotherapy, hormonal treatment in the form of injection once a month/3 monthly.

Kidneys play an important metabolic role and are essential for balancing salt, minerals and water in the body. They also play a significant role in removing waste products from the body. They make urine, which contains all the waste materials that are eliminated from the body. They also play an important role in blood pressure regulation and in maintaining the balance of various minerals in the body. Any suspected kidney damage should be confirmed by a kidney biopsy, which will reveal the exact disease, thereby directing towards the appropriate treatment. 

Why and when is it done? 

A renal or kidney biopsy is done in the following situations: 

1. When there is abnormal protein in the blood or urine, which is indicative of a kidney disease, and the exact cause needs to be found out
2. When kidney failure is suggested by blood tests but cause is not clear 
3. To find the cause of bleeding in the urine (haematuria) 
4. To identify and/or confirm diagnosis after a CT scan or ultrasound 
5. To check how well a transplanted kidney has been received 

Know about the procedure 

A renal biopsy is mostly done as an outpatient procedure and is a type of biopsy known as percutaneous biopsy (biopsy where a needle is inserted through the skin into the renal tissue). Very rarely, it may be combined with the CT scan or ultrasound and be done in the radiology department. This may be done on inpatients. The patient is made to lie on his/her back and a local anesthetic is used on the area of the injection. A thin, long needle is directed towards the area of the kidney from where some kidney tissue is removed for sampling.

In some cases, the direction of the needle may be decided by a CT scan or ultrasound. While this is a closed biopsy procedure, in some cases, as a part of the surgery, open biopsies may also be obtained, where a sample of tissue is extracted for analysis. 

Recovering from a biopsy 
The person would need some time to recover from the procedure, as there would be some discomfort at the site of a needle insertion. Vital signs would be monitored for the next couple of hours during which the person would also be monitored for internal bleeding. A pain reliever can be used if required. Haematuria or blood-tinged urine can be seen disappearing within the next 12 hours. Very rarely the bleeding can be severe and require angiography and further procedures. The person should also avoid strenuous activities for the next few days. 

In case you have a concern or query you can always consult an expert & get answers to your questions!