What Is an Excisional Biopsy?

An excisional biopsy is a surgical procedure that removes an entire tumor or area of abnormal skin and some of the surrounding skin. The amount of skin taken depends on the thickness of the suspected tumor.

An excisional biopsy is different from an incisional biopsy. During an incisional biopsy, only a portion of the tumor is removed.

The exact type of tumor that’s suspected will influence what type of biopsy is ordered. For instance, incisional biopsies are the favored test for suspected melanoma.

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Excisional biopsies are used to both confirm a cancer diagnosis and remove a tumor during the same procedure. They’re used when a larger sample is needed to determine if a tumor is cancerous. For example, the depth, or the number of skin layers penetrated by a tumor, is an important indicator of melanoma.

In addition to skin cancer, excisional biopsies are also generally used to assess tumors of the:

• muscles
• lymph nodes
• breasts

An excisional biopsy allows doctors to see a more complete picture of a suspected tumor. They confirm a diagnosis and help doctors to accurately stage cancer.

Additionally, they can completely remove the tumor. This means that diagnosis and treatment can all be completed in one step. In some cases, especially with small and early stage tumors, an excisional biopsy might be the only procedure needed.

An excisional biopsy is an outpatient procedure. However, you might receive sedation, so it’s best to arrange a ride to and from your appointment. During your appointment, you might change into a hospital gown that allows doctors to access the area being biopsied.

Once you’re prepared, you’ll receive a sedative, numbing medication to the area being biopsied, or both. A doctor will then make a small cut into your skin so that they can remove the entire tumor and affected area.

In some cases, the doctor will use an ultrasound or X-ray to help guide them during the procedure. If the area is large, you might need stitches to close the incision after the tumor is removed.

An excisional biopsy is a low risk and minimally invasive procedure. However, there’s some risk involved. Potential risks of an excisional biopsy include:

• an infection at the surgical site
• bleeding at the surgical site
• nerve damage
• hematoma (bleeding beneath the skin)

There are multiple types of biopsies. The biopsy a doctor or healthcare professional orders will depend on the type of tumor or cancer suspected. In addition to excisional and incisional biopsies, a doctor might order the following :

• Bone marrow biopsy: A bone marrow biopsy is done by taking a small amount of bone marrow fluid or bone marrow tissue out of a bone. It’s performed with a long needle and is generally done when blood cancers, such as lymphoma or leukemia are suspected.
• Endoscopic biopsy: An endoscopic biopsy is done using a long thin tube called an endoscope. The tube has both a small camera and a tiny instrument on the end. It’s passed into the body to examine and remove tissue from suspected tumors in areas such as the bladder, abdominal cavity, or bronchial tract.
• Needle aspiration biopsy: A needle aspiration biopsy uses a thin needle to remove small pieces of a tumor. It’s sometimes used for lymph nodes or internal organs.
• Shave biopsy: A shave biopsy removes the top layers of skin to test for skin cancers such as basal cell carcinoma.

• Punch biopsy: A punch biopsy takes a deep skin sample of suspected skin lesions and tumors.
• Reflectance confocal microscopy (RMC): RMC is a biopsy technique that uses imaging instead of cutting into the skin. It’s not common in the United States, but it’s offered in a few locations.

Is an excisional biopsy painful?

You’ll receive sedation, local anesthesia, or both before an excisional biopsy. This prevents pain for most people. The area might be slightly sore for a few days afterward, but you shouldn’t be in any significant pain.

How soon will results be available after an excisional biopsy?

The exact time it takes to get results will depend on a doctor’s office or healthcare system, but results generally take about a week. A healthcare professional will likely call you to discuss your results.

If you have a patient access portal, or another online system with a doctor, your results might be available faster.

If a doctor recommends an excisional biopsy, do they suspect cancer?

An excisional biopsy is done when cancer is suspected. However, it doesn’t mean cancer is confirmed. It’s a test for cancer, and you don’t have a cancer diagnosis until the results come back.

A benefit of excisional biopsies is that no matter your diagnosis, your tumor will already be removed. In some cases, your excisional biopsy might be all the treatment you need. Plus, even if it turns out your tumor is noncancerous, you won’t have to worry about future tests or decisions.

Are there any alternatives to an excisional biopsy?

There are multiple types of biopsies. A doctor will order the one that’s best for the type of cancer they suspect. If you’re uncomfortable with the idea of an excisional biopsy, ask a doctor why they’re ordering this specific test. You might have other options. A doctor will let you know if any other type of biopsy is appropriate for you.

An excisional biopsy is a type of biopsy that removes an entire suspected tumor as well as some of the affected skin around it. This type of biopsy is done when a larger sample area is needed to confirm a cancer diagnosis. It’s commonly used for skin, breast, lymph node, and muscle cancers.

Since excisional biopsies remove the entire tumor, they can sometimes completely treat the cancer, especially if the tumor is small and early stage.

Excisional biopsies aren’t right for all types of cancer. A doctor will order the type of biopsy that can best diagnose the type of cancer they suspect you might have.