For most types of cancer, a biopsy is the main way doctors diagnose cancer. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis.

Your doctor may recommend a biopsy if something suspicious is found during a physical exam or other tests. You may have the biopsy in your doctor's office. Sometimes, a biopsy may be performed with the help of an imaging test, such as an ultrasound, CT scan, or MRI (see below). Occasionally, surgery may be needed to get a tissue sample. The type of biopsy you receive depends on where the possible tumor is located. An explanation of the different types of biopsies is below.

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 further testing. This biopsy may be used for a mass that can be felt through the skin or used with image-guided biopsy (see further 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, but appears on an imaging scan. 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, depending on the amount of tissue needed. The type of scan used depends on the location and other factors.
  • Bone marrow aspiration and biopsy. These two 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.