This information leaflet has been produced to give you general information and hopes to answer most of your questions regarding your neck biopsy. It is not intended to replace the discussion between you and the healthcare team but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
What is a biopsy?
A biopsy is a medical procedure that involves taking a small sample of body tissue so that it can be examined under a microscope.
Why do I need a neck biopsy?
You have an abnormality or lump in your neck. This may have been discovered by yourself, or by a doctor, or by a previous scan.
The doctors looking after you are unsure of the cause of this abnormality or lump. They have recommended that you have a neck biopsy to find out what it might be. This will help them decide on the most suitable treatment for you.
Having the biopsy in the radiology department can avoid having a surgical operation to find out more about the lump.
What is an ultrasound-guided biopsy of the neck?
A neck biopsy is a procedure to take a tissue sample of your neck lump. This can be carried out anywhere in the neck, including from a lump within the thyroid gland.
The ultrasound scanner uses high frequency sound waves to make an image of your neck on the screen. The image is then used to guide a needle to the right place in your neck and collect small pieces of tissue. The biopsy sample is sent to the laboratory to be examined under the microscope.
Sometimes the ultrasound scan shows that the biopsy is not actually necessary – in which case, the radiologist or sonographer will explain to you why the biopsy is not being done.
What are the risks?
Bleeding: minor bruising is to be expected, but severe bleeding occurs in only about 1 in 100 of core biopsies.
Feeling faint: about 1 in 100.
Discomfort in neck or arm during procedure: about 1 in 20, and this usually settles down quickly with adjustment of needle position or injecting more local anaesthetic.
Specimen is not enough for a diagnosis: about 1 in 10, in which case the doctors looking after you will decide if further tests are needed.
Are there different types of neck biopsy?
There are two types: fine needle aspiration (FNA) and core biopsy.
FNA, as the name suggests, uses a fine needle – similar in size to that used to take blood samples.
With FNA, there is often no need for local anaesthetic (to make the area numb) because stinging from local anaesthetic can be more uncomfortable than the FNA itself.
If FNA is unlikely to give a complete answer, you may need a core biopsy. This decision will be guided by the doctors looking after you.
In a core biopsy, the needle is slightly thicker than for FNA, so that a larger tissue sample can be taken. For a core biopsy, you will have local anaesthetic injected to numb the area before the biopsy is carried out.
How should I prepare for the biopsy?
You may eat and drink normally.
Take your regular medications as usual, unless we advise you otherwise.
Some patients may need to stop taking certain medications for a few days before the biopsy, because of the effect on blood clotting.
This includes anticoagulants (e.g. heparin, warfarin, apixaban, dabigatran, rivaroxaban) and antiplatelet agents (e.g. clopidogrel, dipyridamole).
If you take such medications, and have not yet been given any advice, then please contact the radiology nurses on 0191 445 3260.
Can I bring a relative or friend?
Into the waiting room: yes.
Into the scanning room: not usually, to help maintain aseptic (clean) conditions during biopsies and procedures.
What does the procedure involve?
A member of staff will show you into the scan room, where you will meet the radiologist or sonographer.
They will explain the procedure, how it will be performed, and the risks involved. They will go through a short checklist of safety questions, and confirm that you give your consent for the biopsy to go ahead.
You may be asked to change into a hospital gown.
You will be asked to lie on your back on the ultrasound couch.
The radiologist or sonographer will spread some gel on the skin of your neck and use the ultrasound probe to find the area of concern. When the area has been found, they will clean an area of skin of your neck with antiseptic fluid, and then insert a needle to take the biopsy.
Local anaesthetic is used for core biopsy, but is not always needed for fine needle aspiration.
It may be necessary to take more than one sample.
The whole procedure takes approximately 20-30 minutes.
Does it hurt?
Most people feel only a scratch or minor discomfort during the biopsy.
If local anaesthetic is used, this causes a stinging sensation followed by numbness.
What happens after the procedure?
You may be asked to sit in the department for a short while (up to 15 minutes).
You can eat and drink as normal.
Avoid vigorous physical activity for 24 hours after the biopsy.
Most people are comfortable enough to go back to work the same day or the following day.
If you have concerns after the biopsy – such as suspected bleeding – then please seek urgent attention from 999, 111, or the Emergency Department at the hospital.
When do I get the results?
The results of your biopsy will usually be available about one week later.
The doctors looking after you will either contact you or arrange an appointment to see you.
