Question

Difference between incision and excision

Answer 1

An incisional biopsy is a procedure in which a small area of tissue is taken to identify the composition (or make-up) of a lesion or abnormality. An excisional biopsy is a more involved procedure where the entire abnormality or area of interest is removed.To further clarify this, there are four options for obtaining a tissue sample.A fine needle aspiration is the simplest, least invasive test and uses the smallest needle to simply remove cells from the abnormality. This is not always adequate to obtain a diagnosis, depending on the area to be biopsied.A core needle biopsy removes not only cells, but also a small amount of the surrounding tissue. This provides additional information to assist in the identification of the lesion.An incisional biopsy takes out even more surrounding tissue. It takes out some of the abnormality, but not all. The doctor will slice into the lesion and remove only a portion of it. If the lesion is found to be cancerous, further surgery may be needed to remove the whole abnormality.An excisional biopsy generally removes the entire area in question.If the lesion of interest is large, an incisional biopsy may be performed to make sure the cosmetic outcome following the procedure is suitable. Alternatively, if the abnormality is small, an excisional biopsy may be performed. Ultimately, your doctor will decide what is most appropriate for you based on the location and size of the lesion and the suspected diagnosis.While a core needle biopsy can be performed on most parts of the body, incisional and excisional biopsies are most often used for lesions involving the breast, skin, muscles, and lymph nodes.

How is this test performed?

Incisional or excisional biopsies are generally done to follow up on an abnormality detected on a scan or physical exam. These are typically performed as an outpatient procedure, using local anesthesia (a numbing medicine). Occasionally, depending on the location of the biopsy, a medicine may also be given to help you relax.A small cut in the skin will be made to access to the area. If the area cannot be felt, X-ray or ultrasound can be used to locate the area. Please refer toUltrasound Guided Biopsy orStereotactic Guided Biopsy for more details.The procedure typically takes about an hour. If a sedating medicine is given, you will need to recover for an hour or two. You will also need transportation home as you will not be allowed to drive or leave without supervision.The sample is then sent for review to the pathologist, a doctor who specializes in looking at tissues under the microscope. After the pathologist has established a diagnosis, a report will be generated for your doctor.Similar to any biopsy, the most common risk associated with the procedure is bleeding. A hematoma, or a pocket of blood, can form and collect at the site of the biopsy. This can be uncomfortable but should resolve over the following week. If there is severe pain following the procedure, you should contact your doctor immediately.

How do I prepare for an incisional or excisional biopsy?

If sedation is going to be given, you will need to fast for 6-8 hours prior to the procedure. If only local anesthesia is