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A biopsy is the process of taking a sample of tissue to study under a microscope. A biopsy is always needed to confirm a diagnosis of cancer.
Because the head and neck areas have many delicate layers (often under bone and in vital areas involved in breathing, seeing or hearing or the brain, nerves and muscles), state-of-the-art imaging techniques may be required for a biopsy. This helps ensure that the tissue sample is taken from the proper place. It also protects healthy tissues and organs from damage in the process.
Tissue for a biospy can be removed from the body in several ways:
- Using a needle and syringe
- Using an endoscope. An endoscope is a thin, flexible tube that contains a fiber-optic light and a video camera at the end of the tube. Instruments can be inserted through the endoscope to the tissue to get samples for a biopsy.
- Surgery. The surgeon will make an incision through the skin to the area where a tumor is to collect tissue samples. The examination of the tissue sample is done before the operation so that the surgeon knows how to proceed.
Regardless of how the biopsy is collected, advanced imaging techniques may be used to guide the doctor.
Once the doctor has taken a tissue sample, it is studied by a specialist such as a pathologist or hematologist. (A pathologist is a specialist in examining body tissues for abnormalities; a hematologist is a specialist in examining blood and tissues such as bone marrow that form blood.) Sometimes both may be needed. These specialists seek to find out whether the tissue shows signs of cancer. If so, a pathologist or a hematologist will determine whether the cancer started at the site where the biopsy was taken or spread from some other part of the body.
A biopsy also helps a doctor determine how advanced the cancer is. The stages of cancer range from a scale of one to four. Stage 1 cancers are less advanced than Stage 4 cancers. How a cancer is placed on this scale depends on:
- The size of the tumor
- If (and how) it has spread through the body
- Where it has spread to. For example, has the cancer spread to other organs or the lymph nodes?
- How rapidly is the cancer growing
Knowing the stage of a cancer helps the doctor decide on the best treatment or combination of treatments for an individual patient.