Lung Biopsy

A biopsy is when tissue is removed from lung nodules in order to learn about the makeup of the nodule. The removed tissue is examined under a microscope, which helps physicians diagnose or stage lung conditions, such as cancer or an infection. There are several types of lung biopsies.

What are the types of lung biopsies?

Which type of biopsy should I receive?

The type of biopsy recommended for a patient is based on the location of the nodule or abnormalities that need to be biopsied, the patient’s overall health and the level of skill and training of the practitioners performing the biopsy. Speak with your doctor to make sure you are getting the most up-to-date care available and do not hesitate to seek out a second opinion.

Are lung biopsies safe?

Lung biopsies are generally considered safe, however any lung procedure may carry risks like bleeding, infection and mild pain and discomfort. Rare risks include pneumothorax (collapsed lung), tumor seeding (an extremely rare condition in which the biopsy causes the cancer to spread) and damage to surrounding tissue. This is one reason why it is important to receive care from physicians specifically trained in lung biopsies and minimally-invasive techniques (biopsy and surgical techniques that use no or small incisions) when appropriate for the patient. Biopsies are a key part of the diagnostic and staging process and so the benefits of receiving a biopsy generally outweigh the risks of the procedure. Talk with your doctor about the risks and benefits of lung biopsies.

What will the results of the biopsy show?

The tissue removed from a lung biopsy will be analyzed to determine if it is cancerous, and if so, the type and subtype of cancer (often called histology). Biopsies will often remove tissue from several spots and lymph nodes (small bean-shaped organs) in the chest area. The results inform the patient’s lung cancer stage (how far the lung cancer has spread). Not all suspicious lung nodules are cancer. The tissue from the biopsy can also tell if there are any bacteria, viruses or fungi present. A type of physician called a pathologist reviews the tissue samples from the biopsy to determine the results. In many cases, cancerous lung tissue from biopsies is analyzed for biomarkers, or DNA changes in the cells of the tissue. The results inform if a targeted therapy would be an appropriate treatment option for a patient.

What should I keep in mind when preparing for a lung biopsy?

It is important biopsies are performed in a way that provides the most accurate information to physicians. This includes not only removing enough lung tissue for proper analysis by a pathologist, but having a complete picture of which lymph nodes are cancerous. If a provider does not remove enough tissue, it can be challenging to run a complete diagnostic workup, which often includes comprehensive biomarker testing. This type of testing is recommended for many people with a lung cancer diagnosis, as it shows if there are any cell changes “driving” the cancer to grow and if a patient may be eligible for any targeted therapies. Knowing exactly which lymph nodes are cancerous, ensures a patient is accurately staged, which also informs treatment options. 

Will I need more than one biopsy?

Ideally patients will only need to receive one biopsy, however sometimes a provider is not able to get enough tissue to provide a conclusive diagnosis. If a patient’s lung cancer spreads or comes back, some physicians may recommend another biopsy to see if the cancer has changed in a way that would inform the next treatment decision. A patient might also need a repeat biopsy to determine eligibility for a new drug or participation in a clinical trial. Luckily, newer, less invasive techniques for collecting tissue specimens are available, making re-biopsy more feasible and potentially safer. 

What is a liquid biopsy?

Liquid biopsies refer to when a patient’s blood is analyzed for biomarkers. Liquid biopsies are not typically used to diagnose lung cancer at this time, however they may be an important part of understanding which biomarkers are present in a patient’s tumor.