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Biopsy is a procedure in which a tissue or sample of cell is removed from the body to test for malignant cell under the microscope in the laboratory. X-rays, blood tests or urine tests are the preliminary tests performed, but these alone can not determine cancerous or non cancerous conditions in the body. If certain physical signs and symptoms concern your specialist about cancer, he would recommend a biopsy.

Biopsy is considered the definite diagnostic tool for majority cases of cancer. The type of biopsy to be done will be decided by a specialist, depending on the type and location of cancer suspected.

Types of biopsy

1. Endoscopic biopsy – the type of the endoscopic biopsy to be done will depend on the location of the suspicious area. A thin flexible tube is used with a light on the end to see the body organs internally. Small sample of tissue to be analyzed is taken out by passing special tools through the tube. The tube can be inserted in the body through mouth, urinary tract, rectum or skin. Types endoscopic biopsy include colonoscopy (tissue from colon is collected), bronchoscopy (tissue from lungs is collected) and cytoscopy (tissue from bladder is collected). Anesthesia may be received before the procedure depending on the type of biopsy to be done.  
2. Bone marrow biopsy – bone marrow is drawn out of the hip bone, using a long needle during a bone marrow biopsy. Bone marrow biopsy is generally used to diagnose leukemia, multiple myeloma or lymphoma. To minimize the pain, anesthesia may be given before the procedure.
3. Needle biopsy – needle biopsy is done for the tumors that a specialist can feel physically, such as a breast lump or enlarged lymph nodes. Cells are extracted with the help of special needles from the suspected areas. Needle biopsy includes fine needle aspiration, core needle biopsy, vacuum-assisted biopsy and image-guided biopsy.
4. Skin biopsy – cells are removed from the surface of the body to diagnose skin cancer (melanoma). Skin biopsy procedure may include punch biopsy, shave biopsy, incisional biopsy and excisional biopsy.
5. Surgical biopsy – if a specialist is unable to access the body cells of the suspected areas using the above biopsy methods, he may advise surgical biopsy. This procedure may also be used to eliminate abnormal areas of cell (a part of area or whole area).   

Depending on the type and location of the cancer, these methods are used. For breast cancer, needle or surgical/breast biopsy is used. For prostate cancer needle/prostate biopsy and for liver cancer needle/liver biopsy is used.

The tissue sample may be chemically treated, frozen or sliced in to very thin sections. Then these sections are stained on a glass slide for better enhancement and studied under a microscope. If the results are positive (if cancerous cells are found), then it will help the specialist to determine the location, type and grade of the cancer.

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