What is a biopsy?

A needle biopsy is when your doctor uses a thin needle to take a sample of tissue from an abnormal area. There are 2 types of needle biopsy:

• fine needle aspiration (FNA)

• core needle biopsy

You usually have a needle biopsy under local anaesthetic.

Fine needle aspiration (FNA)

Your doctor uses a thin needle to go through the skin and into the abnormal area. They take out a sample of tissue through the needle and into a syringe.

Your doctor can feel where to put the needle if the abnormal area is near the surface of your skin. For areas deeper in your body, they may use an ultrasound or CT scan to help guide the needle.

Core needle biopsy

This is similar to having an FNA, but the doctor uses a thicker needle. This means they can remove a larger sample of tissue. A core needle biopsy is often more useful than an FNA as it allows doctors to do more tests on the tissue sample.

This is when your doctor uses a scalpel to take a sample of tissue by making one or more small cuts through the skin. They may remove the whole abnormal area if it isn’t too large. For example, they may remove a swollen (enlarged) ​lymph node​ . This is called an excisional biopsy.

Or you may have just part of the abnormal area removed. This is an incision biopsy. This can happen when the abnormal area is too large or too complicated to remove. For example, it might be near an important part of your body.

You have a surgical biopsy under local anaesthetic or general anaesthetic.

An endoscopy is a test that looks inside the body, for example in your stomach or bowel. The endoscope is a long flexible tube that has a tiny camera and light at the end. Your doctor can see the images on a TV screen.

There are different types of endoscopy depending on which part of the body is being looked at. For example:

• a colonoscopy looks at the inside of your large bowel (colon)

• a cystoscopy looks at the inside of your bladder

• a bronchoscopy looks inside your windpipe (trachea) and lungs

• an endoscopic retrograde cholangio pancreatography (ERCP) looks at your liver, pancreas and bile ducts

During an endoscopy, your doctor can put small surgical instruments through the endoscope to take samples of tissue.

Your doctor may want to take samples of your bone marrow. The bone marrow is the spongy tissue that is inside your bones. It makes your blood cells.

During the test, your doctor uses a needle to remove a sample of bone marrow. They may then use a second needle to take out a piece of more solid bone marrow tissue. This is usually from the back of your hip bone. 

Find out how you have a bone marrow biopsy

A lumbar puncture is a test to check the fluid that circulates around the brain and spinal cord. This is called the cerebrospinal fluid or CSF.

Doctors can use a thin needle to take a sample of the CSF from your lower back. They then can check the fluid for cancer or infection.

Read more about how you have a lumbar puncture

Cancer can sometimes cause fluid to collect around the lungs (pleural effusion) or tummy (ascites).

Doctors can take a sample of fluid to check for cancer cells. You usually have this done under local anaesthetic.

Find out more about fluid in the lungs (pleural effusion)

• Find out more about fluid in the tummy (ascites)