Biopsy: Diagnosis and Treatment of Cancer in Israel

Cancer is diagnosed using the following types of biopsies:

• Bone marrow biopsy is assigned in cases where cancer cells are found in the blood, as the blood-forming process occurs in the bones and the problem may originate from there. The sample is usually taken with a long needle from the back of the pelvic bone, although samples may also be taken from other bones. Bone marrow biopsy is used both when there is suspicion of blood cancers such as leukemia, lymphoma, multiple myeloma, and for diagnosing non-oncological blood diseases. In any case, the procedure is performed after taking a sedative or under local anesthesia.
• Endoscopic biopsy is performed during an endoscopic examination, during which the doctor inserts a flexible endoscope equipped with a light source and optics into the body. If a tissue sample needs to be taken, various instruments are passed through the tube. The endoscope is inserted through an opening close to the cancer-affected area of the body (mouth, anus, urethra, or a small incision in the skin). For example, cystoscopy or taking samples from the inner surface of the bladder, bronchoscopy, where a scraping is taken from the surface of the lung, and colonoscopy – biopsy of the colon.
• Needle biopsy is applied to tumors that the doctor can palpate through the skin, for example - suspicious lumps in the breast or enlarged lymph nodes. On the other hand, in combination with X-rays, a biopsy can also be taken from tumors that are not palpable through the skin.

Needle biopsy comes in several types:

1. Fine-needle aspiration – a thin long needle is inserted into the organ, and fluid or cells are taken for analysis using a syringe. It is used for:

• kidney biopsy
• bone marrow biopsy
• breast biopsy

2. Core needle biopsy – a thicker needle with a cutting tip is inserted into the area where cancer spread is suspected to take a tissue fragment for analysis. It is used for:

• prostate biopsy
• bone marrow biopsy

3. Vacuum-assisted biopsy is performed using a suction mechanism that increases the amount of fluid and cells taken for the sample, reducing the number of needle insertions needed to collect sufficient material and making the procedure less traumatic.

Needle biopsy under imaging guidance, such as ultrasound, CT, MRI, allows the doctor to take samples from areas that are not palpable through the skin, such as regions of the liver, lungs, or prostate.

Additionally, some types of biopsies can be performed using additional instruments, such as skin biopsy.

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