Dr. Anderson explains what a biopsy is and the different kinds of dermatological biopsies.
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So today we’re gonna be talking about the procedure of a biopsy. And we take biopsies so that we understand what we’re treating. A lot of times patients just tell me, “Doc, just cut it out. Skip the whole biopsy stuff.” And while that is possible and sometimes it’s what we need because we’re very concerned, clinically for what it might be. Most of the time we’d like to know what we’re treating, before we treat it, so we know how to treat it. In other words, if the biopsy comes back completely normal, then we avoided a big surgery to cut it out from the start. And if the biopsy comes back as something that we need to treat, then we can have an informed discussion with each other, of not only what it is, but your treatment options for it. If we don’t really know what it is, then we can’t really give you educated and appropriate treatment options for it. So that’s why we do a biopsy.
Now we’re gonna show you a video of what that biopsy entails, and there are individual variations for different areas of the body and different biopsy techniques, but for the most part, they’re all the same. Okay, so what we’re gonna do here is demonstrate what a biopsy is, and first thing we do is clean it with alcohol and that’s cold. Then, there’s a little poke and a burn with a needle, so this hurts just a little bit. Ouch, ouch. And then we’re going to do a shave removal of it. We’re trying to go around the lesion, so if it’s not a concerning area, or if the atypia to it is not great, then we don’t have to do anything else except for monitor the area. We will take a sample of tissue, and then we’ll put it in a bottle, and that goes off to the laboratory.
We’ll control the bleeding and give you a bandage to put over the spot that was biopsied. We’ll also give you biopsy care instructions, and if your dermatologist doesn’t have one, you can look down below and use ours, because well, they might not be exactly the same for everybody, they should be fairly universal. So there are different types of biopsies that we can do in your local dermatologist’s office. Some of those are just taking a razor blade looking thing, and taking a shave of it off the top. Sometimes we use a punch device which is like a cookie cutter, and we just punch a hole into the area, and then we control the bleeding afterwards. And then sometimes we’ll do what we call an excisional or an incisional biopsy, which is where we actually take more tissue, and usually put a stitch in to help close it off.
Regardless of the type of biopsy that you’re coming into the clinic for, the aftercare instructions are reasonably the same. So you usually need to keep Vaseline on the area and keep it covered for about two to three weeks, so that a scab does not develop, and so that it heals as well as possible.
Now your local dermatologist will talk to you about how they want your individual biopsy site to be cared for. But if they don’t, you can look down below and look at our handout, and know how to treat these appropriately. Now, it usually takes one to two weeks to get the results back from the laboratory. If it takes longer than that, then please call your local dermatologist and ask them what the holdup is. This doesn’t necessarily mean that it’s a bad diagnosis. Sometimes the lab just has to run extra tests to be thorough, and that’s why it takes a little longer. And sometimes your specimen has to be sent to different locations. So you might end up getting a bill from different locations, depending on what was sampled, from what part of the body, and what specific tests need to be done for us to get you an accurate diagnosis.
Once the pathology report comes back, we will either call you, and tell you over the phone, we might email you, and tell you over an email, or we might ask you to come in in person and discuss it with us. Once you get the results of your biopsy, I’d encourage you to go to Your Health University and look for what the diagnosis is, and also, look at the treatment options that your dermatologist has given you, so that you not only understand your diagnosis, but also can understand what the typical procedure is like to take care of any problem that was found during the biopsy. As always, an educated patient is the best patient, and I want to sincerely thank you for allowing us to help you become comfortable in your skin.
Patient: Now that I’ve had several biopsies that needed to be excised, I have to come in more often, about every three to six months depending on what they think is necessary, and just keep getting reviewed, checked, and keeping an eye on spots that are slightly abnormal. My advice to anyone who’s about to have this procedure or is going to have to have this procedure, is definitely be comfortable with your doctor, and your doctor’s staff, because they are hands-down, a huge portion of making the experience more comfortable, more informative, just educating you on what’s really going on, what you’ll need to know for the future. That is 90 percent of the comfort, and just getting through it emotionally. So I would just make sure that you’re in the know, and that you have a good physician and that you have all the tools you need to move forward, and make better decisions being out in the sun.