Not all patients with cancer will manifest with a lump or mass that is immediately noticeable or accessible. Many patients may present with a constellation of signs and symptoms (Understanding Cancer Series: Signs and Symptoms of Cancer Part 2) that will only reveal itself as cancer after a series of tests.
Around 99% of patients with cancer will require a sample of the tumor to be analyzed by a pathologist before a final diagnosis of is made. Even when we highly suspect that cancer is present, we still need confirmation by a pathologist before we can initiate treatment.
The method of obtaining the tumor sample is known as BIOPSY. There are different ways of performing a biopsy namely:
1. Fine needle aspiration biopsy (FNAB) – This is performed on tumors that are easily accessible from the surface of the body such as on the neck or breasts. The physician simply palpates (touches or feels) the tumor then pokes a small gauge needle attached to a syringe and aspirates cells to be sent for analysis. This is a very easy and convenient method of obtaining a sample of the tumor; the pain from the procedure is very minimal. However, the disadvantage is that it may not yield an adequate amount of cells for analysis.
2. Core Needle Biopsy – This is performed almost similar to an FNAB except that a larger needle is used and this procedure obtains a greater amount of tumor sample. It can produce a little more pain that an FNAB but is still very tolerable.
3. Excision Biopsy – This type of biopsy requires a small surgical incision over the area of the tumor. After the incision is made, the entire mass is removed. However, this is only applicable for small tumors.
4. Incision Biopsy – Similar to an excision biopsy, a small incision is also made. However, only a segment of the tumor is removed not the entire piece. This is usually done for larger tumors that cannot be easily removed.
All of the above procedures can be done on an outpatient basis. The patient does not have to be confined in the hospital. The procedure can be done in 30 minutes or less. These four techniques are the most common but may not be applicable to all cases especially when the tumor is located inside the body. There are instances when patients need to undergo major surgery to be able to confirm the diagnosis.