Can you drive yourself after a biopsy?

Melbourne Haematology

Bone Marrow Biopsy — Post Procedure Instruction

What can I expect immediately after the bone marrow biopsy?

If you have received sedation medication for the biopsy you may feel drowsy for a short period of time. During this time it is important that you avoided driving or operating heavy machinery.

NOTE: If you have received sedation for the procedure you are advised not to drive home following the procedure. You may be discharged from the hospital only when you have fully recovered from the sedation.

Will the biopsy be painful afterwards?

Your doctor will use local anaesthetic during the procedure making the area around the biopsy numb. The local anaesthetic works for a number of hours after the procedure. After the local anaesthetic wears off there may be some discomfort and minor pain at the site of the procedure. Oral pain medication (e.g. Panadol) is usually all that is required to treat this pain. If you find the pain after the procedure particularly difficult to control you should contact the doctor who has performed the procedure.

How do I care for the biopsy site?

Wound and Dressing Care

The doctor performing the biopsy procedure typically makes a very small (2 to 3 mm) skin incision (cut) at the site of the biopsy. This small incision typically heals very quickly and does not require any stitches. Your doctor will place a dressing on this skin incision. This dressing is typically waterproof and you should take this dressing off 1 – 2 days after the procedure (this is often easier in the shower) and inspect the area. After the dressing is removed you can put a Band-Aid on the incision site (particularly if you find your clothing rubs on the the area).

How long will it take for the biopsy site to heal?

The small skin incision will begin to heal immediately. The biopsy is performed with a slightly bigger needle that is used compared to normal blood tests. This larger needle is needed to enter the bone at the back of the hip. After the biopsy the hole in the bone will immediately begin to heal and it is expected complete healing will have occurred within 1 to 2 weeks.

How long does it take for the results of the biopsy?

A bone marrow biopsy typically takes 2 to 4 working days to fully process and for the results of these tests to reach your doctor. Sometimes there are additional tests done on the bone marrow material that can take a number of weeks.

Where can I get more information about the bone marrow test?

A suggested video showing a bone marrow biopsy being performed is available to view on the Melbourne Haematology website. This video was produced by the University of Leicester Medical School as a clinical teaching tool and may give you some idea of what a bone marrow test involves (also referred to here as a bone marrow aspiration and core biopsy). Doctors vary somewhat in the way they approach doing a bone marrow biopsy.

Additional Information

Video Showing a Bone Marrow Aspiration and Core Biopsy

This video was produced by the University of Leicester Medical School as a clinical teaching tool and may give you some idea of what a bone marrow test involves (also referred to here as a bone marrow aspiration and core biopsy). Doctors vary somewhat in the way they approach doing a bone marrow biopsy.

Breast Biopsy

A biopsy is a small piece of tissue that is removed and checked in a lab. For a breast biopsy, breast tissue may be removed with a special biopsy needle. Or it may be removed during surgery. It is checked to see if cancer or other abnormal cells are present.

Why might I need a breast biopsy?

Breast biopsies may be done:

To check a lump or mass that can be felt (is palpable) in the breast
To check a problem seen on a mammogram, such as small calcium deposits in breast tissue (microcalcifications) or a fluid-filled mass (cyst)
To evaluate nipple problems, such as a bloody discharge from the nipple
To find out if a breast lump or mass is cancer (malignant) or not cancer (benign)

A lump or other area of concern in the breast may be caused by cancer. Or it may be caused by another less serious problem.

There may be other reasons for your doctor to recommend a breast biopsy.

Types of breast biopsies

There are several types of breast biopsy procedures. The type of biopsy that you have will depend on the location and size of the breast lump or area of concern.

Biopsies may be done under local or general anesthesia. For local anesthesia, medicine is injected to numb your breast. You will be awake, but feel no pain. For general anesthesia, you will be given medicine to put you into a deep sleep during the biopsy.

Types of breast biopsies include:

Fine needle aspiration (FNA) biopsy. A very thin needle is placed into the lump or area of concern. A small sample of fluid or tissue is removed. No cut (incision) is needed. An FNA biopsy may be done to help see if the area is a fluid-filled sac (cyst) or a solid lump.
Core needle biopsy. A large needle is guided into the lump or area of concern. Small cylinders of tissue, called cores, are removed. No cut is needed.
Open (surgical) biopsy. A cut is made in the breast. The surgeon removes part or all of the lump or area of concern. In some cases the lump may be small, deep, and hard to find. Then a method called wire localization may also be used. For this, a thin needle with a very thin wire is put into the breast. X-ray images help guide it to the lump. The surgeon then follows this wire to find the lump.

Special tools and methods may be used to guide the needles and help with biopsy procedures. These include:

Stereotactic biopsy. With this method, a 3D image of the breast is made using a computer and mammogram results. The 3D image then guides the biopsy needle to the exact site of the breast lump or area of concern.
Vacuum-assisted core biopsy. A small cut is made in the breast. A hollow tube or probe is inserted through the cut. It is guided to the breast lump or mass by MRI, X-rays, or ultrasound. The breast tissue is gently pulled into the probe. A spinning knife inside the tube cuts the tissue from the breast. Several tissue samples can be taken at one time.
Ultrasound-guided biopsy. This method uses ultrasound images of the breast lump or mass. These images help guide the needle to the exact biopsy site.

What are the risks of a breast biopsy?

All procedures have some risk. Some possible complications of a breast biopsy include:

Bruising and mild pain at the biopsy site
Prolonged bleeding from the biopsy site
Infection near the biopsy site

If the biopsy is done using an X-ray, the amount of radiation used is small. The risk for radiation exposure is very low.

You may have other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the biopsy is done.

How do I get ready for a breast biopsy?

Your provider will explain the procedure to you. Ask any questions you have about the procedure.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
Generally, you don’t need to prepare for a biopsy if your breast is numbed (local anesthesia) but you are awake. But if you are given medicine to put you into a deep sleep (general anesthesia), you must not eat or drink anything (fast) for some time before the surgery. Your surgeon will give you specific instructions.
Don’t use lotion, cream, powder, deodorant, or perfume on your arm, underarm, or breast on the day of the procedure.
Tell your provider if you are pregnant or think you may be pregnant.
Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines (local and general).
Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines. It also includes vitamins, herbs, and other supplements.
Tell your provider if you have a history of bleeding disorders. Let your provider know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop taking these medicines before the biopsy.
If you have a sedative or general anesthesia, make sure you have someone drive you home afterward. You will not be able to drive after the biopsy.
Your healthcare provider may have other instructions for you based on your medical condition.

What happens during a breast biopsy?

A breast biopsy may be done in a provider’s office. It may be done on an outpatient basis, which means you go home the same day. Or it may be done as a hospital stay. Some types of biopsies only require local anesthesia. For other types, general anesthesia is needed. Procedures may vary depending on your condition and your provider’s practices.

Generally, a needle breast biopsy follows this process:

You will be asked to remove any clothing from the waist up, and given a gown to wear.
You will lie down or sit up. This depends on your provider’s preference and if X-ray or ultrasound guidance will be used.
The skin over the biopsy site will be cleaned with a sterile solution.
When a local anesthetic is used, you will feel a needle stick when the medicine is injected. You may feel a brief stinging feeling. The biopsy will not start until the area is numb.
When ultrasound is used, the probe will be placed on your breast to find the breast lump or mass.
When stereotactic imaging is used, you will lie face down with your breast placed in an opening on the table. A computer will find the exact site of the breast lump or area of concern.
You will need to lie still during the procedure. But you won’t need to hold your breath.
The provider will place the needle right into the biopsy site or through a tiny cut (incision). He or she will remove a sample of tissue or fluid. You may feel pressure when the doctor takes the sample.
Pressure will be applied to the biopsy site until the bleeding stops.
If needed, the opening will be closed with stitches or adhesive strips.
A sterile bandage or dressing will be applied.
The tissues will be sent to the lab for examination.

Generally, an open breast biopsy will follow this process:

You will be asked to remove clothing and given a gown to wear.
An IV (intravenous) line may be started in your arm or hand.
You will be placed on the operating table.
You may be given medicine (a sedative) to relax you.
If local anesthesia is given, you will feel a needle stick to numb your breast tissue.
If general anesthesia is given, the anesthesiologist will keep checking your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
In some cases, a special wire will be placed into the lump before the biopsy, guided by X-ray images. This is to help the doctor find the breast lump or mass. Other X-ray-guided methods may be used.
The skin over the surgical site will be cleaned with a sterile solution.
A small cut will be made in your skin and underlying breast tissue until the lump or mass is exposed.
A part of the lump or the full lump will be removed.
The opening will be closed with stitches or adhesive strips.
A sterile dressing or bandage will be applied.
The tissue will be sent to the lab for exam.

What happens after a breast biopsy?

How long it takes to recover will depend on the type of biopsy you had and the type of anesthesia used.

If you had general anesthesia, you will be taken to the recovery room, where you will be watched closely. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Or you will go home. If the biopsy was done on an outpatient basis, you should plan to have another person drive you home.

If you had local anesthesia, you will be able to go home after you have completed the recovery period.

At home

Keep the biopsy area clean and dry. If stitches were used, they will be removed during a follow-up office visit. If there are no stitches, you may remove the bandage or dressing when instructed to do so, and bathe as normal.

The biopsy site may be sore for several days after surgery. Take a pain reliever as recommended by your doctor. Aspirin or certain other pain medicines may increase your chance of bleeding. Be sure to take only recommended medicines. Wearing a supportive bra may help with mild pain.

You may go back to your normal diet unless your doctor advises you differently. You may be told to avoid strenuous physical activity for a few days.

Call your healthcare provider if you have any of the following:

Fever or chills
Redness, swelling, bleeding, or other drainage from the biopsy site
Increased pain around the biopsy site

Your healthcare provider may give you other instructions, depending on your situation.

Next steps

Before you agree to a test or procedure, make sure you know:

The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how will you get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure

Seminar A Breast Radiologist’s Perspective: Screening Mammography and Diagnostic Imaging

Breast imaging experts explain breast imaging and the difference between screening and diagnostic mammograms.

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Liver Biopsy

A liver biopsy is a procedure in which a doctor takes a small piece of tissue from your liver. A pathologist will examine the tissue with a microscope to look for signs of damage or disease.

Are there different types of liver biopsy?

Yes. In each type of liver biopsy, doctors take the sample of liver tissue in a different way. Common types of liver biopsy are described below.

Percutaneous liver biopsy

In percutaneous liver biopsy, the doctor inserts a needle through your skin in the upper part of the abdomen to take a small piece of your liver tissue.

Percutaneous liver biopsy is the most common type of liver biopsy and has been performed routinely for many years. Your doctor may perform an ultrasound or computed tomography (CT) scan to be sure that the needle is positioned in the correct place.

Transjugular liver biopsy

In transjugular liver biopsy, a doctor inserts a needle into a vein in your neck called the jugular vein. The doctor passes the needle through your veins to your liver to take a small piece of tissue.

Doctors usually perform transjugular biopsy in people who have a higher risk of problems with percutaneous liver biopsy. For example, bleeding after a percutaneous biopsy is more likely in people who have problems with blood clotting. In people who have ascites—a buildup of fluid in the abdomen that is a complication of cirrhosis—percutaneous biopsy is difficult because the liver is too far away from the skin and hard to target.

Transjugular biopsy also allows doctors to measure pressure in the veins of the liver at the same time that they perform the biopsy.

Surgical liver biopsy

If you need a liver biopsy and you are having surgery for other reasons, a doctor may perform a liver biopsy during the surgery.

Why do doctors use liver biopsy?

Doctors use liver biopsy to

diagnose liver diseases when doctors can’t confirm a diagnosis with blood or imaging tests
find out how severe the liver damage or disease is
help determine the best treatment for liver damage or disease
find out how a treatment for liver disease is working

How do I prepare for a liver biopsy?

To prepare for a liver biopsy talk with your doctor, have blood and imaging tests if needed, arrange for a ride home after the procedure, and follow your doctor’s instructions about fasting before the procedure.

Talk with your doctor

Talk with your doctor about what you can expect before, during, and after the liver biopsy.

Also talk with your doctor about any allergies and medical conditions you have and all the prescribed and over-the-counter medicines, vitamins, and supplements you take, including

aspirin or medicines that contain aspirin
blood thinners
complementary or alternative medicines
diabetes medicines
dietary supplements
nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, or medicines that contain NSAIDs

Your doctor may ask you to temporarily stop taking medicines that affect blood clotting or interact with sedatives. You may receive sedatives during a liver biopsy to help you relax and stay comfortable.

Have blood and imaging tests

Before you have a liver biopsy, your doctor may order blood tests to find out how well your blood clots. For blood tests, a health care professional will take blood samples and send the samples to a lab.

Severe liver disease, inherited bleeding disorders such as hemophilia, and other health conditions may cause problems with blood clotting. If you have problems with blood clotting, your doctor may give you a transfusion of platelets or clotting factors just before a liver biopsy. Your doctor may also recommend a transjugular liver biopsy instead of a percutaneous liver biopsy.

Your doctor may also order imaging tests to view your liver and surrounding organs and find the best place to insert the biopsy needle. Imaging tests may include

ultrasound, which uses a device called a transducer that bounces safe, painless sound waves off organs to create images of their structure
CT scan, which uses a combination of x-rays and computer technology to create images

Arrange for a ride home

For safety reasons, most people cannot drive home after a liver biopsy. You will need to make plans for getting a ride home after a liver biopsy.

Follow your doctor’s instructions about fasting before the procedure

Doctors may ask people to fast—not eat or drink anything—for several hours before a liver biopsy. In some cases, doctors ask patients to eat a small snack a few hours before a liver biopsy. Instructions about fasting vary, and doctors may give different instructions for different types of biopsy. Follow your doctor’s instructions.

How do doctors perform a liver biopsy?

Doctors perform a liver biopsy at a hospital or outpatient center.

Percutaneous liver biopsy

The doctor will find the best place to insert the biopsy needle by tapping on your abdomen or by using ultrasound or a CT scan. Doctors may also use ultrasound or CT scans to guide the biopsy needle during the procedure.

You’ll receive a local anesthetic to numb the area where the doctor will insert the biopsy needle. If needed, you may also receive sedatives and pain medicine.

You will be asked to lie on your back and rest your right hand above your head. The doctor will make a small cut in the right side of your abdomen and insert the biopsy needle. You may be asked to breathe out and hold your breath while the sample of liver tissue is taken.

After the biopsy, the doctor will place a bandage over the cut on your abdomen. You may be asked to lie on your right side after the biopsy, and you will need to remain lying down for a few hours. Health care professionals will typically check your vital signs regularly for 2 to 4 hours after the procedure. 1

Transjugular liver biopsy

The doctor will use ultrasound to find the best place on your neck to access your jugular vein. During the procedure, the doctor will use ultrasound to view your jugular vein and will use fluoroscopy, a type of x-ray imaging, to view the veins between your neck and your liver.

You’ll receive a local anesthetic to numb the area on your neck where the doctor will insert the biopsy needle. You may also receive sedatives and pain medicine.

You will be asked to lie on your back and turn your head to the side. The doctor will make a small cut on your neck and use a needle to make a small hole in your jugular vein. The doctor will insert a thin, flexible tube, called a catheter, through your veins to your liver. The doctor will thread a biopsy needle through the catheter and into your liver to take a tissue sample.

After the biopsy, the doctor will place a bandage over the cut on your neck. You will need to remain lying down and have your vital signs regularly checked for at least 4 hours after the procedure. 2

Surgical liver biopsy

You will receive anesthesia for surgery. Doctors can perform a liver biopsy during open surgery or laparoscopic surgery. In open surgery, doctors make a large cut to open the abdomen. In laparoscopic surgery, doctors make small cuts in the abdomen and insert special tools to view or repair organs and tissues.

What should I expect after a liver biopsy?

Following a liver biopsy, you—or a friend or family member who is with you if you’re still groggy—will receive instructions on how to care for yourself after the procedure. You should follow all instructions. Instructions may vary, depending on the type of liver biopsy you had.

Talk with your doctor about when you can resume your usual activities. After a liver biopsy, doctors often recommend avoiding intense activity and heavy lifting for up to 1 week.

After a liver biopsy, a pathologist will examine the biopsy tissue with a microscope to look for signs of damage or disease. Biopsy results typically take a few days or longer to come back.

What are the risks of liver biopsy?

The risks of liver biopsy include complications such as the following.

Bleeding

Internal bleeding is a serious complication of liver biopsy. Bleeding may cause signs and symptoms such as pain that is severe or that lasts more than a few hours after the biopsy, low blood pressure, and a fast heartbeat. You may need treatment at a hospital, blood transfusions, and sometimes surgery or another procedure to stop the bleeding.

Bleeding occurs in about 1 out of every 500 liver biopsies. Severe bleeding occurs in 1 out of every 2,500 to 10,000 liver biopsies. 1

Pain

Pain is the most common complication after a liver biopsy. Pain often occurs in the upper right abdomen or right shoulder. In most cases, the pain is mild and goes away within a few hours after the biopsy. If pain is severe or lasts longer, it could be a sign of internal bleeding.

Talk with your doctor if you have any pain after a liver biopsy. Your doctor may recommend or prescribe medicines for pain. If the pain is not mild or does not go away within several hours after the biopsy, your doctor may order tests to find the cause of the pain.

Other complications

Uncommon complications that may occur after a liver biopsy include

infection, which may lead to sepsis
a collapsed lung, called a pneumothorax
a buildup of blood in the space between the lung and the chest wall, called hemothorax
injury to other organs

Seek care right away

If you have any of the following symptoms after a liver biopsy, seek medical help right away

bleeding, pain, redness, or swelling at the biopsy site or where the doctor made a cut to insert the biopsy needle
dizziness, fainting, or weakness
fever
nausea or vomiting
pain in your abdomen, shoulder, or chest
problems breathing or shortness of breath
racing or pounding of your heart
stool that contains blood or is black and tarry
swelling or bloating of your abdomen

References

[1] Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American Association for the Study of Liver Diseases position paper: liver biopsy. Hepatology. 2009;49(3):1017–1044.

[2] Dohan A, Guerrache Y, Boudiaf M, Gavini JP, Kaci R, Soyer P. Transjugular liver biopsy: indications, technique, and results. Diagnostic Interventional Imaging. 2014;95(1):11–15.

Last Reviewed August 2019
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Don C. Rockey, M.D., Medical University of South Carolina