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A percutaneous biopsy is a medical procedure in which a needle is inserted through the skin to collect a sample of interest. The term “percutaneous” literally means “through the skin,” with this term being used specifically to refer to a needle biopsy, rather than an open surgical biopsy in which the patient is cut open to expose the area of interest for the purpose of collecting a sample. Percutaneous biopsies are much less invasive, and they are also quicker than traditional surgical biopsies, with a reduced healing time and less risk of complications.
Several different techniques can be used to obtain a sample in a percutaneous biopsy. In a core biopsy, a large-bore needle is inserted and used to pull out a chunk of soft tissue or bone. In fine needle aspiration (FNA) biopsy, a smaller needle is inserted and a syringe is used to create a vacuum, sucking a sample up into the needle. Larger biopsy needles can be used in a vacuum-assisted biopsy, in which a larger sample or even a small growth can be removed with the use of a vacuum device.
If a biopsy is being used to take a sample of a palpable growth, a percutaneous biopsy will involve palpation of the area to identify and isolate the area of interest, followed by a careful insertion of the needle to collect a sample. In cases where a growth is harder to identify, ultrasound may be used to guide the biopsy needle, ensuring that it ends up in the right place.
The main drawback to percutaneous biopsy is that it is less precise than open surgical biopsy, since it is difficult to see exactly where the needle is going. The choice to use percutaneous biopsy rather than an open surgical biopsy also eliminates a chance of seeing the surrounding area to look for signs of tissue death, other growths, and signs of other problems, which means that sometimes the severity of a condition is underestimated. It can also be more challenging to pull out entire growths, a technique sometimes used when a problem looks small, with the surgeon removing problematic tissue and sending it away for biopsy to confirm that it was a problem and to check the margins of the tissue to make sure that the malignant growth was fully excised.
Percutaneous biopsy is often an option when a biopsy needs to be taken, and a doctor can discuss the various options along with their pros and cons. In some cases, it may be necessary to perform an open surgical biopsy for various reasons, but in other instances, a doctor may be willing to be flexible to address a patient's concerns.