The goal of a biopsy is to use the least invasive approach to gain the most useful information for a mesothelioma diagnosis. A biopsy can determine if an abnormality is cancer as well as what type it may be. Some cancers can provide doctors a complete diagnosis from few cells. Other cancers are very complex and require larger biopsies to provide more information to complete the diagnosis. Because most cancers of type mesothelioma are rare and complex, it usually requires a larger biopsy for doctors to feel confident they have a complete diagnosis.
These are some common types of biopsies that may be discussed with you. These procedures may occur at the time of your initial diagnosis or throughout your diagnosis to retrieve more information:
1. Fine needle aspiration (FNA) is the simplest biopsy for mesothelioma. The procedure involves inserting a thin, hollow needle through the skin to reach the intended region. It only requires a local anesthetic and is quick.
2. Core needle biopsy is very similar to a fine needle aspiration, but the size of the needle is larger, so more cells can be withdrawn.
3. Incisional biopsy is when a surgeon makes an incision to remove a small sample of tissue.
4. Thoracoscopy procedure involves undergoing general anesthesia and a surgeon uses a camera scope to look inside the chest cavity and take a biopsy from the lung or pleura. This can also include a thoracentesis at the same time, which involves removing fluid from the lung cavity.
5. Mediastinoscopy involves undergoing general anesthesia and the surgeon sampling lymph nodes from the center of your chest. This usually happens after a confirmation of mesothelioma and helps determine the stage of your cancer.
6. Laparoscopy procedure also involves general anesthesia and the surgeon uses a camera scope to look for abnormalities that may be too small to be seen on imaging studies. They can take several biopsies in the abdominal cavity, including the omentum or other organs. This is often paired with peritoneal washings, where the surgeon instills a salt-water solution into the abdomen and then removes the fluid to screen it for cancer cells.
Although these invasive procedures have risks, they offer more tissue, which is helpful information for diagnosis.