What you Must Know about a Biopsy
An important diagnostic tool during your cancer journey is biopsy that is generally undertaken by a pathologist. Biopsies are an important means to evaluate cells in different types of tissues. Biopsies are a valuable aspect of cancer treatment especially in cases of cancer metastasis. Biopsies are also invaluable tools to determine changes in the genetic composition to ascertain the right treatment options and make accurate predictions about the chances of recovery. In most cases of breast cancer, pathologists can successfully detect estrogen and progesterone receptors using biopsies. Such insights can lead to targeted therapies.
There are certain important aspects of biopsies you must know to understand the decisions of your physicians:
- Your biopsy may be performed in difficult settings including your doctor’s office or the outpatient setting.
- The time taken for a biopsy typically varies between 15 and 30 minutes, based on where the tissue sample for evaluation is preserved. Sometimes, the biopsy may have to be repeated in some cancer types such as certain lymphomas to be able to determine the cancer subtype. This may take 24 to 96 hours with more time required for complex cancer cases.
- You may be advised a pinch biopsy, shave biopsy, cervical biopsy, or a pap smear depending on the type of your cancer and your cancer spread. Another type of biopsy is the fine needle aspiration biopsy (FNAP) for the lymph nodes and the thyroid.
- You may be often intimated to repeat your biopsy when either your tissue sample is small or when it was not extracted from the right location. Repeating the biopsy may give you a more accurate diagnosis.
- Once a biopsy sample is retrieved, it is stored safely in a laboratory for a defined period of time such as five years. Stained tissues and paraffin blocks for processing tissue are stored for 10 years. The tissue sample is generally saved for review later to determine the cancer recurrence or the development of new cancer in future. Sometimes, biopsy samples are also stored for use in targeted therapies and drug discovery initiatives.
- The goal of analyzing a biopsy sample is to obtain a correct diagnosis. Sometimes, greater certainty in the diagnosis may be achieved by performing additional tests such as immunostains to determine tumor origin.
Furthermore, biopsies are excellent starting points for second opinions. A pathologist may generally share the tentative diagnosis with peers. Joint decision-making is especially useful for cancer cases that may be difficult to diagnose or treat, and is a standard practice to confirm a diagnosis. Another important approach in tumor diagnosis is the participation of pathologists in tumor board review, which helps in planning cancer treatment through the involvement of a team of doctors belonging to multiple specialties. A cross-disciplinary team helps to obtain an accurate and detailed diagnosis.
Could a Second Opinion on Biopsy Possibly Save Lives?
According to Varn (2014), difficulties in the interpretation of results of biopsies can be resolved through a medical second opinion. Such an approach has the potential to uncover a number of diagnosis and treatment options. Research evidence indicates that the number of biopsies performed annually in the United States increased from 1,380 to 1,945 between 1997 and 2008. The number was ascertained for every 100,000 Medicare patients, which calculates to a 3% growth rate every year. This study indicates that the error rate could be problematic and affects patient outcomes (Kwan et al., 2010). Furthermore, researchers at the Johns Hopkins Hospital indicated that 1.4% of the patients from a population of 6000 cancer patients across the United States received an updated diagnosis after a second opinion. An interesting aspect of this revised diagnosis was that it classified 23% of the patients as benign who were originally diagnosed as malignant (Sirota, 2000).
Therefore, results of research studies indicate that a second opinion proves beneficial in obtaining an accurate diagnosis and raising the chances of survival. Biopsies have other advantages too as they could help identify infectious and autoimmune conditions.
Research Perspectives on Second Opinion for Biopsy: Brimo and colleagues (2010) identified that a second opinion in pathology was reflected in the actual therapy administered to patients. They analyzed cases related to prostate needle biopsy prior to radical prostatectomy for a year to compare pathological parameters. In doing so, they included a range of diagnosis including malignant and benign cancer. On measuring parameters using the Gleason score, core highest cancer percent, positive core number, and other assessments, researchers concluded that “mandatory second opinion on prostate needle biopsy results” had positive effects on cancer therapy.
Educating Patients on Cancer Biopsy: A patient needs to be educated on the minimally invasive nature of biopsy to improve overall patient outcomes. Relevant information that may be be shared encompasses:
- Mode of placement of biopsy needle using ultrasound, X-ray machines, and computed tomography
- Ability to perform the procedure on any part of the body including bone marrow, abdominal organs, breasts, prostate, and lungs
- Setting chosen which is an outpatient clinic
- Instances when target area is not accessible and an invasive surgery may be required
- The purpose of sample collections which is to identify abnormal cells and determine the need for specialized tests for personalized treatment approaches
The Role of KareOptions in your Cancer Journey
KareOptions is a market leader in providing personalized services to patients. If you have been diagnosed with cancer after a biopsy, then a second opinion may be a prudent way to move towards an optimal treatment plan. To explore our Medical Second Opinion Service (MSOS) and Second Opinion Board Review (SOBR), please visit www.kareoptions.com
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- Kwan, S.W., Bhargavan, M., Kerlan, R.K. and Sunshine, J.H. (2010). Effect of Advanced Imaging Technology on How Biopsies Are Done and Who Does Them. Radiology, 256(3), pp.751–758.
- Sirota, R.L. (2000). Mandatory second opinion surgical pathology at a large referral hospital. Cancer, 89(1), pp.225–226.
- Varn, M. (2014). Medical Second Opinions on Biopsy Results. [online] PinnacleCare. Available at: https://www.pinnaclecare.com/highlights/blog/second-opinions-biopsy-results-save-lives/.