Tests and Procedures
Since I was unable to post yesterday, I am doing two this evening. This is from CancerNet and is an excellent summary of various tests and procedures. I give you the introduction, the section about biopsies as an example, and a link. This is good to remember if you are scheduled for something or want to understand what a test is for.
Tests and Procedures
This section has been reviewed and approved by the Cancer.Net Editorial Board, 3/10
- Different tests and procedures are used to both diagnose cancer and determine its stage.
- The most common types of tests used are biopsy, imaging tests, endoscopic tests, and laboratory tests.
Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. Diagnostic tests may include a biopsy, imaging tests, endoscopic tests, and blood and urine tests; the most common diagnostic tests are described below. When choosing a diagnostic test(s), your doctor will consider the person's age and
and medical condition, the type of cancer that is suspected, the severity of the symptoms, and previous test results.
A biopsy is the removal of a small amount of tissue for examination under a microscope. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. The sample removed during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). There are different types of biopsies.
Fine needle aspiration biopsy. This test uses a thin, hollow needle in a syringe to collect a small amount of fluid and cells from the suspicious area.
Core needle biopsy. A core biopsy uses a slightly larger needle to obtain a cylinder of tissue. It is often done instead of a fine needle aspiration biopsy because it provides more tissue for the pathologist to analyze.
Vacuum-assisted biopsy. This type of biopsy uses vacuum pressure (suction) to collect the sample tissue through a specially designed hollow needle. This technique allows the doctor to collect multiple or larger samples from the same biopsy site without having to insert the needle more than once.
Image-guided biopsy. An image-guided biopsy is a procedure in which the doctor uses imaging technology, such as ultrasound, fluoroscopy, a computed tomography (CT or CAT) scan, x-ray, or a magnetic resonance imaging (MRI) test, to determine the exact location where the tissue sample will be removed for analysis. (Find more information about these imaging tests is in the next section of this article.) An image-guided biopsy may be used when a suspected tumor appears on an imaging scan, such as an x-ray, but cannot be felt by the doctor, or when the area is located deeper inside the body. Once the area to biopsy is located, a needle is used to obtain a sample of the tissue from the site. The type of imaging technology used depends on the location of the biopsy site and other factors.
Surgical biopsy. In a surgical biopsy, a surgeon makes an incision in the skin and removes some or all of the suspicious tissue. It is often used after a needle biopsy shows cancer cells, or it can be used as the first method to obtain tissue for diagnosis. There are two types of surgical biopsies:
- An incisional biopsy is the removal of a piece of the suspicious area for examination. An incisional biopsy may be used for soft tissue tumors, such as those from muscle or fat tissue, to distinguish between benign (noncancerous) lumps and cancerous tumors called sarcomas.
- An excisional biopsy removes the entire lump. An excisional biopsy, which was more common before the development of fine needle aspiration, may be used for enlarged lymph nodes or breast lumps, or in situations where the lump is small enough to be completely removed in one procedure.
Endoscopic biopsy. An endoscope is a tube with a camera that doctors use to view the inside of body, including the bladder, abdomen, joints, or gastrointestinal (GI) tract. The person may be sedated as the tube is inserted into the body. An endoscope can be inserted through the mouth or a tiny surgical incision. Using an endoscope, the doctor can see any abnormal areas and remove tiny samples of the tissue using forceps that are part of the endoscope. For more information on the use of endoscopy, see below.
Bone marrow aspiration and biopsy. A bone marrow aspiration and biopsy is a diagnostic examination of the bone marrow, the red, spongy tissue inside of bone that has both fluid and solid parts. The sample is usually collected from the back of the hip bone. For this test, the patient's skin is numbed with a local anesthetic, and a needle is inserted into a bone in the hip until it reaches the bone marrow. A small amount of bone marrow fluid is removed and examined under a microscope. This is called an aspirate. The doctor may also use a hollow needle in the same location to withdraw a solid core of bone marrow. This is called a biopsy. This test is used to determine if a person has a blood disorder or a blood cancer, such as leukemia or multiple myeloma. It can also be used to find out if a cancer that started in another part of the body has spread to the bone marrow. Learn what to expect during a bone marrow aspiration and biopsy.