Excisional Biopsy

What is an excisional biopsy?

An excisional biopsy is a procedure for complete removal of a lump or abnormal area from the skin or other part of the body. The tissue is then sent to a lab for tests.

When is it used?

The biopsy is done to look for cancer, infection, and inflammation. It is often used to confirm a diagnosis. In some cases it may also be done to treat a problem, such as removal of a small skin cancer.

Examples of other types of biopsies that may be done are:

• incisional biopsy (cutting out part of the lump)
• needle biopsy (using a needle to take a tissue sample).

How do I prepare for an excisional biopsy?

• Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.
• If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. Also avoid medicines that contain aspirin, such as some cold medicines. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before the procedure.
• If you may be given a sedative before the surgery, you should not eat or drink anything for 12 hours before surgery.

What happens during the procedure?

The biopsy may be done at your provider's office, an outpatient clinic, or the hospital.

You will be given a local anesthetic. The anesthetic numbs just the skin and tissues that will be cut. You may also be given a sedative. A sedative helps you relax and may put you to sleep.

Your healthcare provider will cut into or through the skin and remove the abnormal tissue. Your provider will then close the cut with stitches. The tissue is sent to the lab for tests.

What happens after the procedure?

Keep the area of the cut dry. Do not put lotion, medicine, or ointment on it unless your healthcare provider tells you to.

Minor discomfort is common after a skin biopsy. Usually keeping the biopsy site elevated, reducing your activity, and putting a cool, dry compress (crushed ice in a zip lock plastic bag covered with a cloth) is sufficient for relief.

If you feel more than minor discomfort, consider taking a nonprescription anti-inflammatory drug, such as ibuprofen. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason. If you are allergic to this class of drugs, or your pain is not relieved, call your healthcare provider.

Follow all of the instructions given to you for care of your wound. Wound care (dressing changes and wound cleansing) depend on the site and size of the biopsy. Ask your healthcare provider about how and when to change dressings, how to clean the wound, and when you can get the area wet. If the wound was closed with stitches (sutures), your provider will tell you when to return for removal of the stitches.

The results of the lab tests will be available in 1 to 3 days or longer, depending on the tests that are done. Ask your provider when to call for results of the biopsy.

What are the benefits of this procedure?

The procedure helps in diagnosis of cancer, infection, and inflammation. You and your healthcare provider can then decide on a treatment plan.

What are the risks associated with this procedure?

• The local anesthetic may not numb the area quite enough and you may feel some minor discomfort. If this happens, more anesthetic will be used. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.
• There are some risks when you have sedation. Discuss these risks with your healthcare provider.
• You may have bruising around the biopsy site.
• You may have infection or bleeding.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• Your pain or symptoms get worse.
• You have any unusual drainage from the biopsy site, including bloody drainage.
• The biopsy site becomes red and warm.
• You have a fever of 100°F (37.8°C) or higher.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.