Image guided Needle Biopsy

A needle biopsy or needle aspiration is a medical test that can identify the cause of an abnormal lump or mass in your body. Using imaging guidance e.g., ultrasound, mammogram, CT or fluoroscopy the doctor inserts a small needle into the abnormal area and removes a sample of the tissue, which is given to a pathologist, who examines it under a microscope.

The pathologist can determine whether the abnormal tissue is a noncancerous tumour, cancer, an infection or a scar.

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Preparation for the Needle Biopsy
  • No special preparation is required.
  • Blood may have to be taken to check for any clotting problems. This may be done the day before or on the morning of the procedure.
  • Fasting may be necessary for 4-6 hours prior to the procedure, depending on the site for biopsy.
  • If it is arranged for you to do the procedure as a day case, please come early to the hospital for admission, at least 2 hours prior to your appointment.
  • If it is to be done as an outpatient, please bring along a companion and be punctual for your appointment.
  • If you are already in the hospital, you will be transported to the department at your appointed time.


What is the procedure like?
  • Some form of imaging equipment is used e.g., X-ray, CT, Ultrasound or Mammography to determine the site of the mass and the best route of entry.
  • The area will be cleaned and the radiologist will give you a local anaesthetic injection to numb the skin and soft tissue over the area in question.
  • You will be awake during the biopsy but you should have little or no discomfort.
  • Sometimes an intravenous line will be started so that you can receive fluids and medicines during the procedure.
  • The radiologist will use the imaging equipment to guide the small needle into the mass or lump. You may feel some pressure during the procedure.
  • Using a biopsy needle, the radiologist will remove a tiny piece of tissue or some cells from the abnormal area.
  • The tissue is sent to the laboratory for examination under a microscope.
  • The tiny skin incision is closed with a small compression dressing.
  • For breast lesions, a clip may be placed at the site where the mass is to ensure that the site can be easily located for additional surgery if this is necessary.
  • Sometimes, repeated passes with the needle may be necessary in order to obtain an adequate sample.
  • The examination is completed in less than an hour.

What happens after the biopsy?
  • You will stay in the department for a brief time so that the staff can make sure you are alright.
  • You will then be transported to a day surgery bed to rest.
  • Mostly you may go home after about one to four hours after the biopsy.
  • In the case of a lung biopsy, serial chest x-rays may be taken to detect and track any air leaks as a result of the biopsy.
  • Keep physical activity to a minimum for the remainder of the day after the biopsy.
  • The biopsy area may be tender or sore for one or two days.


What are the benefits and risks of the procedure?

BENEFITS
  • Needle biopsy is an alternative to surgical biopsy.
  • It can often answer whether a mass is cancerous or not without the need for surgery.

RISKS
  • There are a few risks as a small needle is used.
  • Complications are infrequent and fewer than 1% of patients develop bleeding or infection.
  • In about 90% of patient, needle biopsy provides enough information to determine the cause of the abnormality. 0ccasionally, a second needle biopsy or surgery biopsy is required.
  • For lung needle biopsies, there is a risk of coughing up blood. This is usually small and self-limiting. There is also a risk of an air leak into the chest space surrounding the lung. This is called a pneumothorax . If it is large, it may cause the lung or part of the lung to collapse. When this happens, a small tube may need to be inserted into the chest cavity to drain away the air.



SERVICE IS AVAILABLE AT:

Radiology Department,
Gleneagles Hospital

6A Napier Road
Singapore 258500
Tel: (65) 6470 5730
Fax: (65) 6470 5749
Radiology Department,
Mount Elizabeth Hospital

3 Mount Elizabeth, Level 2
Singapore 228510
Tel: (65) 6731 2100
Fax: (65) 6732 3368
   
Radiology Department,
Mount Elizabeth Novena Hospital
 
38 Irrawady Road, Level 2
Singapore 329563
Tel: (65) 6933 1188
Fax: (65) 6933 0526