Ultrasound guided biopsy

Download and print as a PDF (370kB pdf)

What is an ultrasound guided biopsy?

A biopsy is a way of taking a sample of tissue out of your body, using a needle, so that it can be examined under a microscope by a pathologist, an expert in making diagnoses from tissue samples. The doctor doing the procedure will use ultrasound imaging to guide them to get the sample.

Why do I need an ultrasound guided biopsy?

Other tests that you probably have had performed, such as an ultrasound scan or an MRI / CT scan, will have shown that there is an area of abnormal tissue inside your body. From the scan, it is not always possible to say exactly what the abnormality is due to, and the simplest way of finding out is by taking a sample for a pathologist to examine. For most people the abnormal area being biopsied will have a benign (non-cancerous), cause, but sometimes it is due to an underlying cancer; a biopsy is the best way of finding this information and ensuring people who do have a cancer are referred to the appropriate specialist team for their care and management.

Who has made the decision?

The radiology diagnostic team will have discussed the situation and reviewed any investigations you have had so far and feel that this is the best option. The team is made up of consultant radiologists (doctors who specialise in imaging procedures), a clinical nurse specialist (CNS), and a patient pathway co-ordinator. However, you will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out, then you can decide against it.

Who will be doing the ultrasound guided biopsy?

A specialist doctor called a radiologist. Radiologists have special expertise in preforming image guided procedures.

Where will the ultrasound guided biopsy take place?

In the imaging department, is an ultrasound room. You will be checked into the department by a nurse or healthcare assistant, who will ask some medical questions and fill out some paperwork. The radiologist will then come and talk to you about the procedure. You will have the opportunity to ask any questions or raise any concerns, and only if you are happy to continue with the procedure will you be asked to sign the consent form.

What actually happens during an ultrasound guided biopsy?

You will lie on the ultrasound table, in the position that the radiologist has decided is most suitable. The radiologist will keep everything as sterile as possible. Your skin will be cleaned with antiseptic, and you may have some of your body covered with a sterile drape. The radiologist will use the ultrasound machine to decide on the most suitable point for inserting the needle. Your skin will be anaesthetised (numbed) with local anaesthetic, and the needle inserted into the abnormal tissue. The local anaesthetic is given through a very small needle and may sting a little.

While the first part of the procedure may seem to take a while, actually doing the biopsy does not take very long at all. It is likely that 2 or 3 biopsies will be taken during this procedure but the needle may be in and out so quickly that you barely feel it. However, there is a ‘clunking’ sound that you might hear – this is caused by the action of the equipment when the tissue sample is taken and is nothing to worry about. The doctor, a nurse or healthcare assistant will cover the area with a small dressing / plaster.

How do I prepare for ultrasound guided biopsy?

To prepare for the procedure you will need to make sure you do the following:

You may need to have a blood test before your procedure. Please let us know if you are taking any antiplatelet medicines (for example, Aspirin, Clopidogrel) or any medicines that thin the blood (for example, Warfarin, Rivaroxaban), as these may need to be stopped temporarily before the procedure.

Contact the team for advice as soon as you get your appointment letter on 01273 696955 extension 63803 or [email protected] and ask to speak to the nurse specialist or support worker.

Will it hurt?

When the local anaesthetic is injected it will sting for a moment but the stinging will wear off leaving that area of skin numb. The procedure shouldn’t be painful, but if you feel pain tell the radiologist looking after you.

How long will it take?

Whilst every patient and every patient’s situation is different we allow 30 to 45 minutes for this procedure.

What happens afterwards?

You may be required to recover in our recovery area and will stay in the department for up to 2 hours after the procedure. Please arrange for someone to pick you up and take you home.

What are the risks?

An ultrasound guided biopsy is a very safe procedure, but there are a few risks or complications that can arise, as with any medical treatment, these include:

• Bleeding
• Bruising
• Infection
• Nerve ending irritation

Not all biopsies are successful, for example normal tissue is obtained not abnormal, so it may need to be repeated.

What are the benefits?

It is a minimally invasive and quick procedure that is very safe. It obtains information to diagnoses the cause of an abnormal area of tissue ensuring the right treatment is offered.

Afterwards

Typically, patients will be in the department for a short period of time. You will need to have a responsible adult to take you home. Continue with your normal medication as prescribed, unless otherwise advised. The area may continue to feel sore / tender for a few days afterwards. If you are having some mild pain you can take over-the-counter painkillers such as paracetamol (follow the instructions on the packet).

Don’t drive for 24 hours after the procedure. The dressing can usually be removed 24 hours after the procedure. The area may appear red and a little swollen: this should resolve in 2 or 3 days.

A little bit of oozing through the dressing may occur but if you notice bleeding or a pus-like discharge please contact your GP or call 111. It is extremely unlikely for the bleeding to be a lot but if it is or you feel you need urgent medical attention you may need to visit your nearest A&E department.

When will I get the results?

The results will take 1 to 4 weeks to process. Sometimes they are sent to a specialist centre for analysis and this means it may take a bit longer to get the results – if this happens you will be informed by the CNS or a support worker.

The results will either be sent to your GP or you will have an appointment with the clinical nurse specialist. If the appointment is with the CNS a nurse or support worker will contact you to discuss if you would prefer to hear the results over the phone or come to a face to face appointment. The face to face appointments are held at Hove Polyclinic.

Finally

Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the team looking after you. Make sure you are satisfied that you have received enough information about the procedure before you sign the consent form.