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Incisional & Excisional Biopsy

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Excision is the surgical removal of a small amount of tissue or growth on the skin, such as an abscess or cyst, or in other parts of the body for treatment or testing, such as to diagnose a disease like cancer and to stage it.

Biopsy is the removal of tissue specifically to test it in the laboratory to confirm the type and severity of disease. Samples are looked at under a microscope to determine abnormalities in the cells. There are many different ways of collecting tissue for testing, depending on the location. The doctor may use small tools or a microscope or the procedure may need to be done in the operating room.
 

Types of Biopsy
  1. Incisional biopsy, where a small amount of tissue is removed
  2. Excisional biopsy, where all the tissue is removed
  3. Fine need aspiration, where a needle is inserted through the skin into the area so cells can be removed for testing
Local anesthesia doesn’t need any special preparation. Often a biopsy is done in a procedure room on an outpatient basis.
 
  1. The doctor will first clean the area with an antiseptic solution.
  2. A drape will be placed with an opening for the biopsy. A local anesthetic will be administered.
  3. The doctor will use a scalpel to remove the growth or tissue sample.
  4. If the sample must be sent to the laboratory, it will be frozen in a container or bag with formalin to preserve the cells. The container will be clearly labeled with your name and hospital number as well as where the tissue was removed from and, if applicable, on which side (left or right). This information will match the paperwork for testing the sample.
  5. Samples taken from different parts of the same patient’s body will be separated into different containers and labeled clearly to ensure the most accurate testing and diagnosis.
  6. Certain samples may be labeled differently depending on how they need to be tested.
  7. If the sample is small, you can usually return home after the procedure. Your doctor will let you know whether or not you will need to stay in hospital.
  1. The wound(s) will be dressed and covered. You will be given instructions on caring for the wound until you see your doctor again. If stitches were placed, you will likely return in 7-10 days to have them removed. Please keep your wound dry.
  2. You can shower normally and wash your hair. The dressing is usually waterproof.
  3. Avoid soaking in a tub for at least 1 week.
There are always risks and complications associated with surgery, as follows:
  • Collection of fluid under the wound and seeping of fluid while the wound heals
  • Tightness or scabbing as the wound heals
  • Irregular healing of the wound/incision, causing scarring
  • Raised scar as the wound heals, which may be a different color than the skin and may feel tender
Please see your doctor immediately if you have a fever, if your wound comes apart, and if you notice swelling, redness, warmth, pain, and/or pus at the site.
  • If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
  • Travelers to Thailand should plan to stay in the country for at least 1 day or, depending on their condition after the procedure, for the entire duration of treatment.
  • If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel.
  • During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "fit to fly" certificate (if needed).
Please discuss the likelihood of success with your doctor before the procedure.
 
What if the procedure is not performed?
Please discuss specific risks of not having the procedure done with your doctor.
 
In many cases where a surgical biopsy is indicated, there are no alternatives to removing the tissue sample needed for further analysis to confirm cancer and/or develop a plan of treatment. Choosing not to undergo this procedure can lead to metastasis (which can be life-threatening) or growth of noncancerous cells to the extent that it affects other organs.

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