The major role of surgery in the diagnosis of cancer lies in the acquisition of tissue for exact histologic diagnosis. Endoscopic approaches are replacing many open surgical procedures for diagnostic purposes.2 Laparoscopic staging procedures may identify metastatic or unresectable disease so the person affected by cancer may avoid a major operation.1
Biopsy procedures include:1, 2
- Fine needle aspiration biopsy: the least invasive procedure. It can be performed in an outpatient setting and is least likely to cause tissue damage. A positive cytology result may indicate the need for further surgery.
- Core needle biopsy: involves the removal of a 1.0 - 1.2mm core of tissue through a hollow needle under local anaesthetic. It provides a larger specimen for histopathological investigation.
- Incisional biopsy: refers to removal of a small wedge of tissue from a larger tumour mass using a scalpel or punch biopsy instrument.
- Excisional biopsy: involves excision of the entire suspected tumour tissue with little or no margin of surrounding normal tissue.
An important principle in the diagnosis of cancer is that only positive biopsy findings are definitive. A negative biopsy can mean no cancer but it can also mean that the specimen was not representative of the tumour. If a high index of suspicion for cancer exists, another biopsy should be done.1, 2
The person affected by cancer will often be anxious during the diagnostic phase. The SCN can alleviate or minimise this by providing timely and sensitive information on when the results will be available, how they'll be informed, and what to expect during and after the procedure.
For each of the biopsy procedures listed below, complete the following learning activities:
- Describe a specific indication
- Identify potential complications of the procedure
- Outline the supportive care and information provision role the SCN may have in the following procedures:
- Fine needle aspiration biopsy
- Core needle biopsy
- Incisional biopsy
- Excisional biopsy.
Summarise the role of the SCN in preparing and supporting a person undergoing: