Getting a Needle Biopsy

Needle biopsies are a minimally-invasive alternative to open surgery

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Using interventional radiology techniques, a needle biopsy allows radiologists to obtain a small tissue sample for laboratory evaluation from nearly any part of the body with less discomfort, cost, and recovery time as compared to open surgery.

Typically, abnormal tissue is detected by symptoms, a physical exam, and radiology tests. When a diagnosis can’t be made by other testing methods, a biopsy may be required to help identify the cause of the abnormality. For instance, a mass in the lungs or abdomen may or may not be cancerous. A needle biopsy provides a tissue sample that can be examined under a microscope to determine if cancer cells are present.

With the help of interventional radiology techniques, nearly any mass in any part of the body can be biopsied. Ultrasound, CT scan, MRI, fluoroscopy, and mammography techniques can guide needle biopsy making the procedure safe and accurate. Needle biopsy may also avoid the need for a more invasive open surgical evaluation.

When is needle biopsy recommended?

For any abnormal tissue detected in the body, including a mass, lump, infection, or inflammation, a needle biopsy may help establish a diagnosis.

Needle biopsies may be recommended in the following body areas:

Abdomen – to identify cause of an abnormal mass
Bone – to diagnose bone cancers and infections
Bone marrow – to diagnose cancers, such as leukemia
Breast – to determine if a mass is cancerous or benign
Endometrium (uterine lining) – to evaluate cause of abnormal uterine bleeding
Kidney – to evaluate masses, causes of kidney failure, and assess the health of a transplanted organ
Liver – to evaluate masses, diagnose other diseases (infections, cirrhosis, etc.), and assess the health of a transplanted organ
Lung – to determine if a chest nodule is cancerous or diagnose infection
Lymph nodes – to identify cause of lymph node enlargement
Muscle – to diagnose muscle infections, metabolic disorders, and problems with blood vessels
Nerve – to determine the cause of nerve damage or dysfunction
Testicular – to determine the cause of male infertility or evaluate a testicular nodule
Thyroid – to establish the diagnosis of a thyroid nodule

What are the benefits and risks of needle biopsy?

Needle biopsy is minimally invasive and can be performed as a day procedure. This reduces overall risk, complications, and recovery time.
Needle biopsy may eliminate the need for a more extensive open surgical biopsy.
The rate of complications is very low for needle biopsy.
With the help of imaging techniques, needle biopsy is very safe and accurate.
Needle biopsy can usually be done under local anesthesia, and the recovery time is minimal.

Risks

Needle biopsy uses a very small dose of radiation, and the benefit from accurate diagnosis and successful treatment far outweighs the risk. Please see ARA’s information on Radiation Safety.
There is a very small risk for contrast allergy. If you have had an allergic reaction to contrast material in the past, your radiologist may recommend that you take medication for 24 hours before the procedure to reduce risk.
While extremely rare, there is a risk of serious allergic reaction to iodinated contrast. ARA radiologists and staff are well prepared in the event of such a reaction.
The American College of Radiology (ACR) says that current information suggests that breastfeeding is safe after the use of intravenous contrast. Please discuss your breastfeeding options with your physician.
Women should always inform the scheduler, physician, and technologist if they are pregnant. It may be necessary to use an alternate exam.
Patients with diabetes or kidney disease may experience kidney damage from the contrast material. To check for this, a small amount of blood will be drawn before the procedure to check kidney function as well as clotting ability.

What should I expect?

Needle biopsy is done in an ARA imaging center, hospital, or medical center. Depending on the complexity of the procedure, your exam may last from one hour to several hours.
You may be asked to remove all metal and jewelry, and you will be asked to change into a gown.
Before the exam, a paramedic or technologist will start an intravenous (IV) line in your arm or hand. A small amount of blood will be taken to check for kidney disease and clotting ability.
Electrodes may be placed on your chest to monitor your heart function during the procedure.
You will be positioned comfortably on the exam table. At this point, a dose of sedative may be delivered through the IV to help you relax.
The area to be biopsied will be located using imaging such as ultrasound, CT scan, MRI, mammogram, or fluoroscopy. Once the location is confirmed, your skin will be marked to show where the biopsy needle will be inserted.
The skin over the biopsy site will be sterilized and covered with a sterile drape. You will be given an injection of local anesthetic. A small incision will be made at the site.
With the help of imaging guidance, the doctor will insert and advance the needle to the location of the abnormal tissue to be biopsied. Several samples of tissue may be taken.
When all the samples are taken, the needle is removed.
Pressure will be applied to the biopsy site to minimalize bleeding and a small bandage will be applied.
The IV line is removed, and you will be taken to a quiet area to rest and wake up under observation.
If you are sedated for the procedure, you should have someone with you who can drive you home. You should not drive for 24 hours after your exam.

How should I prepare?

Please let your health care provider and your scheduler know of all medications you are taking and if you have allergies, especially to iodinated contrast material. Also let them know about recent illnesses or ongoing medical conditions.
Wear comfortable, loose fitting clothing. You may want to leave all jewelry, piercings and any other metal objects at home.
If you take any blood-thinning medications, aspirin, or products containing aspirin, please contact our office for instructions on discontinuing the medications prior to your procedure.
You will be asked to remove clothes over the area being examined and to wear a gown. Depending on the exam you may be asked to remove jewelry, glasses, dental appliances or any metal objects that might interfere with the scan.
Women should always inform the scheduler, referring provider, and technologist if they are pregnant. It may be necessary to use an alternate exam.
Some health care providers recommend that breastfeeding women wait 24 to 48 hours until the contrast clears from their system before breastfeeding again. Before the procedure, breastfeeding women may want to pump breastmilk to have on hand.
If your exam plans include giving you a sedative, you may be instructed not to eat or drink for 4 to 8 hours before the exam. Please discuss this with your ARA scheduler to get instructions.
If you are sedated, please plan to bring a friend or relative to drive you home. You will be kept for observation at the facility until you are cleared to leave and should not plan to drive for 24 hours following the exam.

How do I schedule?

To schedule a needle biopsy please speak with your doctor and call our interventional team at (512) 467-XRAY or (512) 467-9729. A provider referral is required to make an appointment.

How do I get my results?

The health care provider who referred you to ARA for the needle biopsy will contact you with the results.