Types of biopsies

The types of biopsies include:

Fine needle aspiration biopsy. For this type of biopsy, the doctor uses a very thin, hollow needle attached to a syringe. A small amount of tissue is collected from the suspicious area for examination and more testing. This biopsy may be used for a mass that can be felt through the skin. It can also be used with image-guided biopsy (see below).

Core needle biopsy. Similar to a fine needle biopsy, a core needle biopsy uses a larger needle to remove a larger sample of tissue.

Vacuum-assisted biopsy. This type of biopsy uses suction to collect a tissue sample through a specially designed needle. This means the doctor does not have to insert the needle more than one time. The doctor can collect multiple or larger samples from the same biopsy site with this method.

Image-guided biopsy. This biopsy may be used when a tumor cannot be felt by the doctor or when the area is deeper inside the body. During this procedure, a needle is guided to the location with the help of an imaging technique. An image-guided biopsy can be done using a fine needle, core, or vacuum-assisted biopsy. The type of scan used depends on the location, amount of tissue needed, and other factors. One of these imaging scans may be used:

Ultrasound

Computed Tomography (CT) scan

X-ray

Magnetic Resonance Imaging (MRI) scan

Fluoroscopy

Incisional biopsy. In an incisional biopsy, the doctor makes a small incision in the skin to collect a sample of tissue from underneath the skin.

Excisional biopsy. An excisional biopsy is the removal of an entire suspicious area. This type of biopsy is common for a suspicious change on the skin. It is also sometimes used for a small lump under the skin when it can be easily removed. However, fine needle aspiration or a core biopsy are more common for lumps that cannot be seen or felt through the skin.

Shave biopsy. For this type of biopsy, the doctor uses a sharp tool to scrape tissue from the surface of the skin. It is most often used for a mass or nodule on the surface of the skin.

Punch biopsy. During a punch biopsy, the doctor uses a sharp, circular tool that is inserted through the skin. It is used to take a sample of the skin and some tissue below it.

Endoscopic biopsy. An endoscope is a thin, lighted, flexible tube with a camera. Doctors use endoscopes to view the inside of the body, including the bladder, abdomen, joints, or gastrointestinal (GI) tract. Endoscopes are inserted into the body through the mouth or through a tiny surgical incision. The attached camera helps the doctor see abnormal areas. It can also be used to take tiny samples of the tissue using forceps. The forceps are also a part of the endoscope. Find out more about the different endoscopic techniques.

Bone marrow aspiration and biopsy. These 2 procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration removes a sample of the fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle. These procedures are used to find out if a person has a blood disorder or blood cancer. Blood cancers include leukemia, lymphoma, or multiple myeloma.

A common site for a bone marrow aspiration and biopsy is the pelvic bone, located in the lower back by the hip. The skin in that area is usually numbed with medication beforehand. Other types of anesthesia (medication to block the awareness of pain) may be used. Learn more about what to expect during a bone marrow biopsy.
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Who does a biopsy and who analyzes the sample?

Because there are different types of biopsies, members of the medical team involved in the procedure may vary.

The doctor who performs your biopsy depends on the type of biopsy you need and what part of the body is being examined. Types of doctors include:

Surgeon

Radiologist, who specializes in taking and reading medical images

Oncologist, who specializes in treating cancer

Gastroenterologist, who specializes in the function and disorders of the gastrointestinal tract. The gastrointestinal, or GI, tract includes the stomach, intestines, and associated organs.

Pathologist, who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The pathologist analyzes the tissue sample(s) removed during a biopsy.

A cytologist, who specializes in the study of cells. This doctor may perform a fine needle aspiration.

Dermatologist, who specializes in skin conditions

Gynecologist, who specializes in conditions related to a woman’s reproductive system

Family practice doctor

Other specialists