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  1. Diagnosis
  2. What tests do I need to have?
  3. Biopsy

Biopsy

A biopsy is the removal of a small piece of tissue for testing under a microscope. Your doctor may recommend a biopsy to see if you have cancer and what type of cancer it is.
Your doctor may recommend different types of biopsies
Incision biopsy is when a doctor removes a small piece of tissue from the affected area using a surgical knife. This can be done in the clinic using an anaesthetic , so that you don’t feel any pain. Depending on the size and location of the biopsy, you may need stitches. There may be some bleeding after the biopsy. If you take blood thinners (e.g. warfarin), you may need to stop these for a few days before the biopsy.
Needle biopsy (Fine Needle Aspiration or FNA) is used when there is a lump (enlarged lymph node) in your neck that could have cancer cells in it. During the procedure, your doctor will take a small sample of cells from the lump using a needle. This is done by a radiologist or pathologist using an ultrasound to see that the needle is in the right spot. You may feel slight discomfort during the biopsy.
Sometimes a larger needle is used to get more tissue in the biopsy. This is called a core biopsy. It can provide more information than needle biopsy but can be more uncomfortable. Your doctor will decide which type of biopsy is most appropriate for you.
Lymph node excision biopsy Lymph node excision biopsy is when a whole lymph node is removed. This is often performed when the needle biopsy does not give an answer as to why the lymph node is enlarged. 
In some people with no swollen lymph nodes or detectable signs of cancer in the nodes, the doctor may recommend sentinel node biopsy to help determine if the cancer has spread to the lymph nodes. Sentinel node biopsy identifies the first lymph node (the sentinel node) to which cancer cells are most likely to spread from your cancer. 

Some people may need a biopsy under a general anaesthetic (medicine to keep you unconscious). This is usually needed when biopsies have to be taken from the throat or voice box (examination under anaesthetic (EUA) or laryngoscopy). It lets your doctor look more closely for unusual things. This is done in a single day so you won’t need to stay in hospital overnight.

The tissue taken during a biopsy is sent to a pathologist to look at under a microscope. It can take a few days or weeks to get your results. After your biopsy, it is normal to feel a bit sore and have some bruising in the area from where the sample was taken. Speak with your doctor or nurse about your options for relieving any pain or discomfort.

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