Incisional & Excisional Biopsy

Author: OncoLink Team
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What are incisional and excisional biopsies?

An incisional biopsy is a medical test to remove a piece of tissue from a lesion or mass. The tissue is then tested to find out what it is. An excisional biopsy is a medical test in which the whole lesion or mass is removed and tested.

Your provider will decide with you which is the better option. This is based on the location and size of the lesion or mass. If the lesion is found to be cancerous, further surgery may be needed to remove the whole thing. Incisional and excisional biopsies are most often used for lesions involving the breast, skin, muscles, and lymph nodes.

How do I prepare for an incisional or excisional biopsy?

In some cases, you will be sedated for the biopsy. In those cases, you will need to fast (not eat or drink) for 6-8 hours before the procedure. If only local anesthesia is used, such as lidocaine, there is no need to fast. Your provider will let you know if you need to fast or not. If you are on blood thinners, your provider will likely have you stop them a few days before the biopsy. You will be given instructions prior to the biopsy regarding fasting and medications.

How is this test performed?

You will be given either general anesthesia or the area will be numbed (local anesthesia.) A small cut in the skin will be made to access the area. The tissue sample will be removed. How the incision is closed depends where the incision is and how large it is. X-ray or ultrasound can be used to locate the area being biopsied. 

What can I expect after my incisional or excisional biopsy?

As the numbing medication wears off, you may have some discomfort. You may have a small amount of bleeding at the site of the biopsy.

If sedation was used, you will need to recover for an hour or two. You will need a ride home, as you will not be allowed to drive.

A hematoma, or a pocket of blood, can form and collect in the area of the biopsy. This can be uncomfortable but should go away within a week. If there is severe pain you should call your provider right away.

How do I receive the results of my biopsy?

The tissue sample is reviewed by a pathologist under a microscope and a report is written. The pathology report provides information about the patient and the reason for the test. The report will likely detail both normal and abnormal findings. Your provider will be able to discuss your results with you. You may want to ask for a copy for your records.

References

American Cancer Society. Types of biopsies used to look for cancer. 2015. Retrieved from https://www.cancer.org/treatment/understanding-your-diagnosis/tests/testing-biopsy-and-cytology-specimens-for-cancer/biopsy-types.html

National Center for Biotechnology Information. Stat Pearls. Excisional Biopsy. 2020. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK534835/

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