Biopsy Report, A Beginner Guide- Everything You Need To Know

Our article: below we are going to talk about the Biopsy Report, What happens to the specimen after the biopsy is done.
And also take a look on the purpose of a biopsy, with some Types of biopsies,and more useful process how to know  your biopsy.

A biopsy report: is also known as a histopathology report or a surgical pathology report. For many health problems, a diagnosis is made by removing a piece of tissue for study in the pathology lab. The piece of tissue may be called the sample or specimen. A pathologist looks at the specimen.

A pathologist is a doctor who specializes in diagnosing what type of disease is found in tissue samples or specimens taken from your body. The biopsy report describes what the pathologist finds out about the specimen. Biopsy report information may differ somewhat, but all reports contain important details that your healthcare provider needs to diagnose and manage your condition or disease.

What happens to the specimen after the biopsy is done?

After the specimen is removed from the patient, it’s put in a container with a special type of liquid to preserve the sample. The pathologist or trained lab assistant reviews the specimen by the naked eye. This means without using a microscope. The pathologist looks at, measures, feels, or takes pictures of the specimen. This type of exam helps the pathologist determine which part of the specimen is the most important. That part will be looked at under a microscope to help diagnose a disease or condition.

Next, the pathologist or a trained lab assistant gets the specimen ready to look at under a microscope. Specimens are processed based on the type of sample sent to the pathology lab. They can be prepared as a histologic section or a smear, as described below.

Histologic sections are very thin slices of the specimen that are stained, placed on a glass slide, and then covered with a thin piece of glass called a coverslip.

Smears are done when the specimen is a liquid or there are small, solid chunks suspended in a liquid. These are “smeared” onto a slide. They are then allowed to dry or are fixed. The fixed smears are stained, covered with a coverslip, and then examined under a microscope

Routine processing and histology can take one day or more. Sometimes information about a tissue sample is needed during surgery to make immediate decisions. A pathology consult can be done during surgery if the surgeon can’t wait for routine processing and histology. This is often called a frozen section exam and usually takes 10 to 20 minutes.

What is the purpose of a biopsy?

A biopsy report describes the findings of the specimen. Most reports contain the following information: or

A biopsy is a procedure to remove cells, tissue or fluid for examination by a medical pathologist. Healthcare providers do biopsies when they identify areas of concern or if you have symptoms or signs of certain conditions. There are different types of biopsy procedures.

What is a biopsy?

A biopsy is one of the ways healthcare providers determine what’s going on in your body. In a biopsy, a provider removes samples of your tissue, cells or fluids so a medical pathologist can examine them for signs of disease. Providers may recommend biopsies to diagnose or monitor medical conditions or to plan treatment.

You may hear the term “biopsy” and think “cancer,” but providers do biopsies to diagnose many medical conditions, like:

Inflammatory disorders, such as in your kidney (nephritis) or liver (hepatitis).
Infections, like tuberculosis.
Immune disorders, such as chronic pancreatitis.
Peptic ulcer disease.
Endometriosis.
Types of biopsies

All biopsies are procedures to obtain samples of tissue and fluid, but they’re done in different ways. Healthcare providers may do biopsies in medical offices or operating rooms. Biopsy types include:

Bone marrow biopsy: Providers use a special biopsy needle and syringe to obtain a small sample of bone marrow. They do bone marrow biopsies to diagnose blood cancers, blood disorders and other diseases.
Cone biopsy: Also known as conization or cold knife biopsy, providers do cone biopsies to remove abnormal tissue from your cervix. Cone biopsies may detect cervical cancer or cervical dysplasia that could lead to cancer.
Excisional biopsy or incisional biopsies: In these procedures, providers make incisions or cuts in your body to remove tissue from inside your body. Excisional biopsies involve removing entire lumps or suspicious areas. Incisional biopsies involve taking tissue samples of lumps or suspicious areas.
Liquid biopsy: This blood test detects signs of cancerous cells or cancer cell DNA.
Needle biopsy: Providers use needle biopsies to extract cells, fluid or tissues. Your provider may order a needle biopsy if they feel an unusual lump or bump on your body or imaging tests detect potential issues.
Punch biopsy: Providers use a special device to remove tissue that may be cancerous. Providers use a special device that punches a hole in your skin’s surface.
Sentinel node biopsy: Providers do this procedure to see if cancer cells have spread from an original tumor.
Shave biopsy: Providers use a razor to scrape up a small sample of skin cells to detect skin cancer.

Test Details

What happens before a biopsy?

Your healthcare provider understands why you may be anxious about having a biopsy. They’ll take time to explain the procedure they’ll use, including whether you’ll be awake or under anesthesia. They’ll also review the following information so they know:

What medications you’re taking, including over-the-counter medications, prescription medications, vitamins and herbal supplements.
Whether you have allergies, including being allergic to latex. Providers typically wear latex gloves when they perform biopsies.
Your current health. Your provider will know about the medical issues that require biopsy and any other medical conditions, but they may ask if you have new issues. For example, they may ask about viral infections such as colds or flu.
If you might be pregnant.
Your provider will also let you know if you’ll need to:

Stop eating or drinking fluids before your biopsy.
Temporarily stop taking certain medications, such as aspirin or blood thinners.
Arrange for a ride home after your biopsy.
Need someone to stay with you for a few hours while you recover.
Finally, your provider will explain what kind of anesthesia they’ll use so you don’t experience pain during the procedure:

Local anesthesia, which numbs a small section of your body.
Regional anesthesia, which blocks pain in a larger area of your body.
General anesthesia, which makes you unconscious and unable to feel pain.

When would I know biopsy results?

Waiting for results may be the hardest part of having a biopsy. Your healthcare provider will explain how and when you’ll receive results. Biopsy results may be available within a few hours, a few days or more than a week. Follow up with your provider if you haven’t received the results when you expected.

What happens if my biopsy results show there’s something wrong?

Your healthcare provider will explain test results that detect issues, such as cells that don’t look like normal cells. They’ll also explain the next steps, whether that’s additional tests or planning treatment.

Are biopsy results always accurate?

Biopsies are a very accurate way to detect abnormal cells or other changes in your body that may be signs of issues. That said, studies suggest false-negative results do happen. A false-negative result means you have cancer or another illness that a biopsy didn’t detect. False-negative rates vary depending on the type of cancer or medical condition. If you’re having a biopsy, ask your provider about false-negative rates for that type of biopsy.

A note from Cleveland Clinic

A biopsy is a procedure to remove cells, tissue or fluid for examination by a medical pathologist. They can be stressful. It’s stressful to learn you need one, stressful to go through one and especially stressful while you await results. Your healthcare provider understands all the ways a biopsy may affect you, so don’t hesitate to ask questions.

If you’re having a biopsy, try to remember a biopsy is a test to detect any issues. It doesn’t mean you have cancer or another serious illness. And if your biopsy results show something is going on, try to think of the results as your first step toward getting well. Your provider will help you every step of the way to stay informed and help you make important decisions about your health.

What Do Doctors Look for in Biopsy and Cytology Samples?

After your biopsy and cytology samples have been prepared, a doctor called a pathologist will determine if the cells in the sample are cancer and, if so, provide information about the cancer to help your doctors determine the right treatment options for you.

Here is information about what pathologists look for when they analyze your biopsy or cytology samples.

General characteristics

Various tissues and organs look different from each other under a microscope. This is because they are formed by different types of cells and because the cells are arranged differently. Even more importantly, diseases like cancer can change the usual appearance of each type of cell, tissue, or organ.

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Most tissue and cell samples are looked at by pathologists, doctors with special training in diagnosing diseases by lab tests. Sometimes, other doctors will also examine samples or tissues of organs related to their area of expertise. For example, hematologists (doctors who specialize in blood disorders) often look at blood and bone marrow samples from their patients, and some dermatologists (doctors specializing in skin diseases) will look at their patients’ skin biopsy specimens.

Some features that doctors look for under a microscope are important only if they are found in certain types of tissue, while others are more important if they are found in almost all tissues.

Here are a few general concepts to help you better understand how doctors decide if cancer is present.

Size and shape of the cells

Cancer cells are often abnormal in terms of their size and shape. They may be either smaller or larger than normal cells. Normal cells often have certain shapes that help them do their jobs. Cancer cells usually don’t function in a useful way, and their shapes are often distorted. Unlike normal cells, which tend to have the same size and shape, cancer cells often vary in their sizes and shapes.

Size and shape of the cell’s nucleus

The nucleus is the center of the cell that contains the cell’s DNA. Typically, the nucleus of a cancer cell is larger than that of a normal cell, and its size and shape can vary greatly. And after being stained with certain dyes, the nucleus of a cancer cell looks darker than a normal nucleus. The nucleus from a cancer cell is larger and darker because it often contains too much DNA.

Arrangement of the cells

The arrangement of normal cells reflects the function of each tissue. For instance, gland tissue in the female breast, which produces milk during breastfeeding, is organized into lobules where the milk is made, and ducts that carry the milk from the lobules to the nipple. Cells of the stomach also form glands, to make enzymes and acid that digest the food, as well as mucus that helps protect the stomach lining.

When cancers develop in the breast, stomach, and other glandular tissues, the cancer cells no longer form normal glands like they should. Sometimes they form abnormal or distorted glands. Sometimes they form clumps of cells that don’t look like glands at all.

While normal cells stay where they belong within a tissue, cancer cells often grow into (invade) nearby tissues. The ability of cancer cells to invade reflects the fact that their growth and movement isn’t properly coordinated with their neighboring cells. This ability to invade is how cancer spreads into and damages nearby tissues.

And, unlike normal cells, cancer cells can metastasize (spread through blood vessels or lymph vessels) to distant parts of the body. Knowing this helps doctors recognize cancers under a microscope, because finding certain types of cells where they don’t belong is a useful clue that they might be cancer.

The type of cancer

Different kinds of cancer are often referred to by the organ or part of the body they started in. But cancer types are also named according to which type of normal cells and tissues they look like most.

There are several basic types of cancer, which doctors can further classify into hundreds or even thousands of types, based on how they look under a microscope. For example, cancers that look like glandular tissues are called adenocarcinomas. Other cancers that look like certain immune system cells are called lymphomas, and those that look like connective tissue (such as bone or fatty tissue) are sarcomas.

Grading the cancer

For many types of cancer, doctors also determine how closely the cancer cells and the growth patterns look like the normal cells or tissues. This is the grade of the cancer.

Cancers that look more like normal tissues are called low grade (or well differentiated), while those that don’t look much like normal tissues are called high grade (or poorly differentiated). For some types of cancer, grading might be done using a number scale, such as from 1 to 3, with grade 1 being a low-grade cancer and grade 3 being a high-grade cancer.

High-grade cancers tend to grow and spread faster than low-grade cancers. This might affect a person’s treatment options, as well as their prognosis (outlook).

process to do while being calm and waiting for your results  and what to avoid when protecting your biopsy health

Strategies to remain calm while waiting for biopsy results

For the majority of cancers, the process of receiving a diagnosis begins with a biopsy. The wait for these biopsy results can be incredibly nerve-wracking. Depending on the type of biopsy you’ve had, it can take several days for your results to come back; rest assured, a longer wait does not necessarily mean a positive cancer diagnosis.

Although you can tell yourself to stay calm and be positive, knowing that the results could lead to a cancer diagnosis, or learning that your cancer may have returned, can be an agonising time for you and your loved ones. There is no ‘normal’ way to feel and there are many different ways to cope and try to reduce stress. Below are five strategies to help remain calm while waiting for biopsy results.

1. Try to avoid preemptive worry

It’s natural to feel anxious, but try to avoid focusing on hypothetical outcomes that can add unnecessary emotional burden. Try to remember that you have not been diagnosed with cancer and your results may come back clear.

2. Use a personal mantra

Create a positive mantra for yourself that you can repeat when you’re feeling anxious. Mantras can provide mental strength and resilience while you wait for your biopsy results. We’ve provided some example phrases below; try to find one that works for you.

“I am strong and I will get through this.”

“I will take this one day at a time.”

“I am not defined by test results; I am more than this moment.”

“I have the power to overcome any obstacles.”

“A test does not equal a diagnosis.”

“Deep breaths, stay calm. Everything will be OK.”

3. Connect with loved ones

Spend time with the family and friends and seek emotional support when you need to. For some people, talking to loved ones who understand their feelings can be comforting. For others, a chat simply offers the chance to get things off their chest. Ultimately, try not to go through the wait for biopsy results alone.

4. Keep busy & practice self care

Engage in activities that bring you joy and keep your mind and body occupied. Consider hobbies, visiting your favourite places, reading a captivating book, or physical activities like bike riding or bush-walking. These not only offer a welcome distraction but can also relieve physical tension and help you unwind.

5. Be cautious with Dr Google

While it’s tempting to search for information online, misinformation and worst-case scenarios can wreak havoc on your mindset. If you decide to research, ensure the information comes from reliable sources. We recommend the Cancer Council website alongside our own Icon Cancer Information Library.

For people who suffer from anxiety, waiting for biopsy results can be particularly distressing. It’s important to seek help from a healthcare professional if you are feeling overwhelmed or are struggling to cope. There are also a number of cancer support agencies who specialise in providing assistance to people with cancer and their loved ones, including support to access information and counselling.

What do you say to someone waiting on biopsy results?

If you are a family member or carer, you may be wondering how you can support someone waiting for their biopsy results. Here are some tips on how you can help:

Simply being there for a loved one waiting for biopsy results can help them remain calm. Sometimes an oversupply of advice can create more stress despite your good intentions.
Don’t try to solve your loved one’s problems or tell them a story about someone else you know who has cancer. Just let them know you care and are there to listen and offer a shoulder to cry on if they need it.

Identification and clinical information. This information includes your name, medical record number, date of the procedure, and the unique identifier of the specimen. The clinical information is your medical information and the special request from the healthcare provider who provided the sample.

Gross description. A gross description describes how it looks to the naked eye and where the biopsy was taken from. It may include a description of the color, size, weight, and texture of the specimen.

Microscopic exam. A microscopic exam is a description of what the findings of the slides showed under a microscope. It’s usually technical and not in simple language.

Diagnosis. This is usually considered the “bottom line.” Although the format varies, often the diagnosis is expressed as: organ or tissue, site from which the biopsy was obtained, type of surgical procedure used to obtain the biopsy, and then diagnosis.

Comment. This section is used by the pathologist to address or clarify concerns of your healthcare provider or to recommend additional tests you may need.

Summary (also called a synoptic report). This section consists of a summary of the pathologist’s findings. For example: colon, sigmoid, endoscopic biopsy, tubular adenoma. In other words, you had a biopsy of the sigmoid portion of the colon by endoscopy, and a benign tumor was found.

The name of the pathologist and the  address of the pathology lab is included in the report.

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