An incisional biopsy is a medical procedure where a small section of abnormal tissue or a lesion is removed from the body. This tissue sample is then sent to a laboratory for examination under a microscope. Its purpose is to determine the exact nature of an abnormality, aiding in diagnosis of conditions like infections, inflammatory disorders, or suspected growths.
When an Incisional Biopsy is Recommended
An incisional biopsy is chosen when a suspicious area is too large to remove entirely without significant cosmetic or functional impact. This approach allows a representative sample to be taken from the lesion, providing sufficient information for diagnosis without extensive initial removal. In contrast, an excisional biopsy removes the entire lesion, along with a small margin of surrounding healthy tissue.
The incisional method is useful when the lesion is in a sensitive area, such as the face, where complete removal could lead to disfigurement or impaired function. It is also preferred when a definitive diagnosis is needed to guide subsequent treatment plans, especially before more involved interventions like extensive surgery or radiation therapy. This sampling helps confirm the diagnosis and determine the tissue’s specific characteristics.
The Incisional Biopsy Procedure
Before an incisional biopsy, patients receive instructions from their healthcare provider. Preparation might include fasting if sedation is planned, or temporarily stopping certain medications, such as blood thinners, to minimize bleeding risk. Patients must inform their doctor about all current medications, supplements, and allergies.
During the procedure, the area to be biopsied is numbed with a local anesthetic injected just under the skin. While the injection may cause a brief sting, the area quickly becomes numb, ensuring comfort throughout the biopsy. Once the anesthesia has taken effect, the surgeon cleans and sterilizes the skin around the lesion.
A small cut, or incision, is then made into the abnormal tissue using a scalpel. The surgeon removes a portion of the lesion most representative of the abnormality, often including a small amount of adjacent normal tissue. The tissue sample is gently handled to prevent crushing or damage, preserving its cellular structure for accurate laboratory analysis.
After the tissue sample is removed, the wound is closed with stitches. These stitches may be dissolvable, naturally breaking down over time, or non-dissolvable, requiring later removal. A dressing is then applied to the site to protect the wound and help manage any minor bleeding.
Recovery and Receiving Results
Following an incisional biopsy, patients can expect localized discomfort, redness, and swelling at the biopsy site. Mild pain is managed with over-the-counter pain relievers, such as acetaminophen, as directed by a healthcare provider. A small amount of bleeding is common; applying gentle, direct pressure with gauze for 10 to 20 minutes can control this.
Wound care instructions involve keeping the dressing dry for the first 24 to 48 hours, followed by daily cleaning with mild soap and water. After washing, the area should be gently patted dry, and a thin layer of antibiotic ointment or petroleum jelly should be applied before covering it with a fresh bandage. Non-dissolvable stitches are removed by a nurse within 7 to 14 days, while dissolvable stitches take 7 to 21 days to disappear.
The removed tissue sample is sent to a pathology laboratory, where a pathologist examines it under a microscope. The pathologist analyzes the cells and tissue structure to identify abnormalities and provides a detailed report. This report is then sent to the patient’s referring healthcare provider.
The timeline for receiving biopsy results varies, usually from a few days to one or two weeks, though more complex cases may take longer. Once available, the healthcare provider communicates them to the patient, often during a follow-up appointment. This discussion includes explaining the diagnosis and outlining any further steps or treatment plans based on the findings.