Biopsy: the where, when, how, complications & cost

A biopsy is a medical procedure that involves the taking a part or whole of a tissue using special instruments for analysis especially in the case of suspected malignancy or cancer. The laboratory analysis for a biopsied tissue is called histology.

The are different types of biopsies.

The are:

• Excisional biopsy: Here the whole tissue is removed surgically for histology. For example, most breast lumps are removed wholly and sent for histology.
• Incisional biopsy: Part of a tissue is taken from an organ for analysis. For example, prostate, bone, liver, kidney and skin biopsies are incisional.
• Needle biopsy: Here a special needle is used to take part of a tissue. Most biopsies are done with a needle. There are different types such as core needle biopsy, image-guided needle biopsy, Fine Needle Aspiration Biopsy (FNAC), trucut biopsy etc
• Image-guided biospy: This involves the use of Ultrasound, Magnetic Reaonance imaging (MRI) , Computed Tomography (CT scan), and X-ray to guide the doctor in passing a needle during the procedure. It is expensive and most times used for deep seated tissue tumours or organs such as kidney, pancreas, liver, and some breast tumours. There is now the ultrasound guided breast biopsy.
• Endoscopy biopsy: It is a form of ultrasound guided biospy used for persons with suspected gastrointestinal diseases like stomach ulcer, gastric cancer, colorectal cancer and esophageal tumours.
• Others are punch biopsy and shave biospsy.

Pricelist/Cost of Biopsy in Nigeria

Biopsy is a procedure performed by specially trained doctors in that field. As a doctor I have watched and assisted on so many biopsies but I have not performed any.

The price list of biopsies below were gotten from periods painstaking research and interviews of both hospitals and patients across Nigeria. It may not give you the accurate figure but it will avail you the idea of the cost in Naira.

Please be aware that the cost is dependent on the hospital, the doctor, the location, the type of organ to be biopsied for histology, your clinical state before and after the procedure and whether cost of the histology is included. Most hospital will request you pay for the analysis of the tissue separately from the biopsy while some will request you pay for both the biopsy and the histology at once. Also if it is image-guided, it is more expensive.

Below is a list and the cost of biospy:

• Breast biopsy: #15,000 to #25,000 Naira
• Prostate biopsy: #50,000 to #70,000 Naira
• Skin biopy: #10,000 to #20,000 Naira
• Liver biopsy: #60,000 to #80,000 naira
• Bone marrow biopsy: #25,000 to #35,000 Naira
• Kidney biospy: #50,000 to #80,000 Naira
• Endomentrial biopsy: #15,000 to #25,000 Naira
• Excision biopsy: #40,000 to #60,000 naira
• Cervical biopsy: #10,000- #15,000 Naira
• Endoscopic biopsy: #50,000 to #90,000 Naira. Whatever type.
• image-guided biopsy: You can get this done at Lily hospital or Raytouch Diagnostics in Benin, Cedacrest hospital, Mecure diagnostics, Reddington hospital, Foremost Consultants, Clinix, Eko hospitals, Bridge Clinic and many more in Lagos and Abuja. It is expensive, it cost between #300,000 to #800,000 or more for image-guided biopsies in these centres.
• Testicular biopsy: #20,000 to #40,000 Naira.
• Fine Needle Aspiration Cytology (FNAC) : The cost of biopsy using fine needle aspiration is around #30,000 to #40,000 Naira.
• Bone biopsy: Requested mainly by orthopedic surgeons. The cost of biopsy for bone is between #30,000 to 40,000.
• Thyroid biopsy: #20,000 to #30,000 Naira.

Most biopsied samples are frozen, sliced or put in formalin and sent to the lab for analysis or histology by the pathologists. It may take weeks or sometimes months to report their findings or for the results to be out.

Please note that pain, bleeding and injury to other organs are complications of biopsies worldwide. A skilled doctor will greatly reduce the risk of the procedure. Also, the advent of image guided biopsy though expensive, has minimized the risks.

Note that the histology of biopsied sample give the definitive diagnosis of cancer. It is therefore inevitable in some conditions and helps allay the fear of cancer.

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You can read more about this procedure in Mayoclinic