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What Should You Know About Biopsies?

In a biopsy, doctors conduct an operation to remove a sample of tissue to analyse it under a microscope. If your doctor has recommended you for a biopsy, then he is suspicious that you may have cancer. It is the most accurate way to reach a definitive diagnosis of cancer. However, there are a lot of confusion and disagreement among the experts regarding who should receive a screening test and what the results might indicate. For instance, in a study, a group of pathologists and experts examined the same breast cancer biopsy results but came up with discrete decisions that differed for about 25 percent of the time.

Such disagreements can have a great influence on an individual’s treatment process. The patient may either not receive a life-saving cure when he needs it or may undergo an aggressive treatment when simple measures can prove effective. Moreover, getting a biopsy when there is no such need may cause a lot of problems. It may lead to unnecessary anxiety, heavy expenses, and may pose unwanted risks as biopsies can result in blood loss, soreness and other complications.

Thus, to avoid unnecessary biopsies, it is best to ignore irrelevant screening tests. Here we will take a look at three common cancers and understand when a person needs screening tests and biopsies.

1. Breast Cancer:

As the use of mammography increases, the practice of breast biopsies also rises. About 10% of women ages 49 to 59 who receive a mammogram every year over a decade will be recommended at least once for a biopsy. The results of most of these women will indicate no cancer. But unnecessary biopsies can elicit fear and follow-up tests.

Who should receive a screening test?

At the age of 40, many women start getting mammograms, but there is no evidence that doing so will save your life. Instead, the earlier you receive a screening test, there is a greater chance of you getting a biopsy. So, the U.S. Preventive Services Task Force recommends that women ages 50 to 74 should undergo screening tests every two years. However, other women should consult a doctor to determine whether the test will be useful for them or not.

When do you need a biopsy?

When a doctor senses breast lump or a mammogram reveals mass or minute flecks of calcium assembled in a clump or aligned in a line, then you may need a biopsy.  

When can you wait and see?

If a mammogram does not reveal a definitive result, then most of the radiologists recommend a biopsy, just to be on a safe side. But in such a situation, you can wait and repeat the test after a couple of months. Similarly, if the test detects a small lesion, then it is best to wait.

Are you aware of the following fact?

The results that you obtain after a biopsy can be vague and confusing. In such a situation, the doctor has to conduct another biopsy to remove a bigger piece of tissue to investigate.

2. Prostate Cancer:

About millions of U.S. men undergo a biopsy, especially after having a PSA blood test. This test measures the abnormal level of protein that cancer cells produce. But a PSA test cannot be reliable as the PSA level can also increase due to excessive cycling, benign enlargement of the gland, or an infection. Moreover, it is common for men to have a harmless type of prostate cancer. However, the PSA test and also the biopsy are unable to differentiate between slow-growing and deadly cancers.

Who should receive a screening test?

The advantages of the routine screening test are unknown, and so the task force does not support routine PSA testing.

When do you need a biopsy?

Firstly, if you detect symptoms of prostate cancer, such as frequent urination and blood in urine or semen or physical exam reveals a lump in the prostate, then you may need a biopsy. In such a situation, a doctor might conduct a PSA test to gather relevant information. If the test reveals higher levels of PSA or if the PSA levels, despite being normal has increased in larger quantities, then you will need a biopsy.

When can you wait and see?

If your doctor conducts a PSA test, and if the PSA level rises moderately, then you should repeat the test before undergoing a biopsy. It is also better to rule out the possibilities of an infection by taking an antibiotic to check whether the PSA level falls or not. Ask your doctor for alternative tests such as MRI or ultrasound that can reveal relevant information.

Are you aware of the following fact?

While conducting prostate biopsies, doctors usually take random samples from the gland in an attempt to obtain representative samples. If the biopsy does not confirm cancer, then you have to undergo a PSA test and biopsy after one or two years.

3. Skin Cancer:

Melanomas and other types of skin cancer affect a large number of people. Thus, the practice of skin biopsies has also risen. Skin is the most accessible organ, and so many physicians can undergo skin biopsy without any difficulty.

Who should receive a screening test?

Each person should carry out a periodical check-up of their skin to detect any form of abnormal growth. If you discover a mole whose shape, size, and colour are different from the existing ones, or if you observe a worrisome change in your skin, then immediately consult a doctor.

When do you need a biopsy?

If a sore does not heal and appears again, and if it bleeds and hurts a lot, then you need a skin biopsy. You also need a biopsy when a mole aches and bleeds excessively.

When can you wait and see?

If you have a lot of moles all over your skin, then the doctor may not remove all of them. Instead, he may take pictures of them to see the changes that occur over the course of time. He may refer you to a trained expert to track mole development.

Are you aware of the following fact?

A specialist called dermatopathologist have great expertise in reading biopsied moles and detecting worrisome growths. This specialist may use multiheaded microscopes so that various experts can examine the mole at the same time.

Screening tests can be helpful, but many times it can cause you to undergo unnecessary biopsies, which can do more harm than good. So, talk with your doctor and choose them judiciously. You can also follow USPSTF recommendations that are available online. Remember, extra knowledge is not always a good thing; sometimes it is better to remain ignorant.

References:

  1. The cancer tests you need and those you don’t.

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Tasneem

Tasneem

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