Principles of Biopsy Needling
Mar 09, 2022
Biopsies of bone and soft tissue tumors should be performed after a thorough history, physical examination, imaging studies, and staging have been completed. There are three reasons:
(1) Imaging data can determine the characteristics and local size of the tumor, and whether it has metastasized.
(2) Surgical tumor staging can clarify the anatomical level of the tumor and the area of tumor invasion.
(3) Imaging after biopsy may confuse true tumor boundaries and imaging findings. Therefore, in principle, biopsy should be performed after comprehensive imaging studies and staging have been completed. Except for some bone and soft tissue tumors that can be diagnosed before surgery, it is not a tumor that requires biopsy.
Basic principles of biopsy:
(1) Before biopsy, it should be paid as much attention as the formulation of surgical plan, and it is best to make careful plans after discussion with doctors in the department of imaging, pathology and bone tumor surgery.
(2) The principle of aseptic operation should be strictly followed, skin preparation should be carried out, hemostasis should be done carefully, non-invasive intradermal suture should be performed or the margin of incision suture should be reduced.
(3) Ensure that the biopsy does not affect the formulation of future surgical plans, that is, the incision or channel for open biopsy and closed biopsy must be on the surgical incision used in the future, so that these potentially contaminated tissues and biopsy channels can and must be in the final surgery. be completely excised.
(4) Identify the site that best represents bone and soft tissue tumors before biopsy.
(5) The biopsy channel should be as short as possible to reach the tumor tissue. Important limb blood vessels and nerve bundles must be avoided, and too many tissue compartments must not be involved.
(6) Ensure that there are enough representative tissue specimens for the pathologist to diagnose. If the pathologist cannot make a clear diagnosis, detailed clinical and imaging examination data should be provided in a timely manner.
(7) For lesions that cannot be accurately located on the body surface, imaging equipment must be used to guide them to improve the accuracy of puncture and reduce damage and local tumor spread.
(8) If the doctor or hospital does not have the conditions to diagnose and treat tumors, the tumor patient should be transferred to a doctor or hospital capable of diagnosing and treating tumors for regular diagnosis and treatment before biopsy.
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