Patients may choose excisional biopsy over other biopsy methods because it allows for complete removal and examination of the suspicious lesion, providing a definitive diagnosis to guide further treatment. Additionally, excisional biopsy is considered the gold standard for obtaining a complete tissue sample for analysis, which can lead to more accurate results compared to less invasive techniques.

Improvements and results patients can expect from an excisional biopsy include:

• Receive a definitive diagnosis from the complete tissue sample
• Avoid the need for repeat biopsies or procedures
• Minimize the risk of spreading or missing cancerous cells
• Accelerate the treatment planning process with clear diagnostic information
• Potentially eliminate the lesion or abnormality in a single procedure

Are You a Candidate?

Patients are generally considered suitable candidates for an excisional biopsy if the suspicious lesion or abnormality is localized and accessible for surgical removal. Factors that would disqualify someone include an inability to undergo anesthesia or surgery due to significant medical comorbidities, or if the patient has a bleeding disorder or takes medications that increase the risk of excessive bleeding during the surgery. Additionally, patients with certain infections or active inflammatory conditions may need to delay an excisional biopsy until the underlying condition is brought under control. Overall, the decision to proceed with an excisional biopsy is made on a case-by-case basis, taking into account the patient's overall health status, nature & location of the lesion, and potential risks versus benefits of the surgical procedure.

What to Expect

Before the Procedure

Prior to an excisional biopsy, the patient can expect to undergo a pre-operative evaluation, including a review of their medical history, physical examination, and any necessary imaging or lab tests. The surgical team will explain the procedure in detail, obtain informed consent, and provide instructions on preparing for the surgery, such as fasting beforehand and stopping certain medications.

During the Procedure

During the excisional biopsy, the patient is first given a local anesthetic to numb the area around the lesion. In some cases, the patient may also receive intravenous sedation to help them remain relaxed and comfortable throughout the procedure. The surgeon then makes a small incision and carefully removes the entire lesion, along with a margin of surrounding healthy tissue. This excised sample is sent to a laboratory for detailed analysis.

After the Procedure

Once the biopsy is complete, the incision is closed with sutures or surgical staples. The patient is monitored for a short time to ensure there are no immediate complications, such as bleeding or infection. Before being discharged, the patient will receive instructions on wound care, activity restrictions, and any necessary follow-up appointments.

In the period immediately after the excisional biopsy, the patient may experience some mild discomfort or soreness at the incision site. Over-the-counter pain medication can help manage this. The surgical team will provide guidance on when the patient can resume normal daily activities, typically within 1-2 weeks as the incision heals.

Recovery

The recovery process after an excisional biopsy is generally straightforward, with most patients able to return to their normal daily activities within 1-2 weeks.

In the first few days following the procedure, patients may experience some mild pain, swelling, and bruising at the incision site. Over-the-counter pain medications like acetaminophen or ibuprofen can help manage any discomfort. The surgical team will provide instructions on how to care for the incision, including keeping it clean and dry during the healing process. Patients are typically advised to avoid strenuous activities or heavy lifting during this initial recovery period to prevent any disruption to the surgical site.

Within a week or two, as the incision begins to heal, patients can gradually resume their normal routine. The sutures or staples used to close the incision are usually removed within 7-14 days. By this time, the majority of patients report minimal, if any, residual pain or limited mobility. As long as the surgical site heals properly without signs of infection or other complications, patients can expect to make a full recovery without significant long-term effects. Regular follow-up appointments with the surgeon help ensure the biopsy site continues to heal as expected.