biopsied

A biopsy is a procedure that removes cells or tissue from your body. A doctor called a pathologist looks at the cells or tissue under a microscope to check for damage or disease. The pathologist may also do other tests on it.

Biopsies can be done on all parts of the body. In most cases, a biopsy is the only test that can tell for sure if a suspicious area is cancer. But biopsies are performed for many other reasons too.

There are different types of biopsies. A needle biopsy removes tissue with a needle passed through your skin to the site of the problem. Other kinds of biopsies may require surgery.

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. Your kidneys filter and clean your blood, taking out waste products and making urine. Kidney tests check to see how well your kidneys are working. They include blood, urine, and imaging tests.

Early kidney disease usually does not have signs or symptoms. Testing is the only way to know how your kidneys are doing. It is important for you to get checked for kidney disease if you have the key risk factors - diabetes, high blood pressure, heart disease, or a family history of kidney failure.

Specific kidney tests include:

• Glomerular filtration rate (GFR) - one of the most common blood tests to check for chronic kidney disease. It tells how well your kidneys are filtering.
• Creatinine blood and urine tests - check the levels of creatinine, a waste product that your kidneys remove from your blood
• Albumin urine test - checks for albumin, a protein that can pass into the urine if the kidneys are damaged
• Imaging tests, such as an ultrasound - provide pictures of the kidneys. The pictures help the health care provider see the size and shape of the kidneys, and check for anything unusual.
• Kidney biopsy - a procedure that involves taking a small piece of kidney tissue for examination with a microscope. It checks for the cause of kidney disease and how damaged your kidneys are.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.

Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.

Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.

There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:

• Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
• Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
• Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
• Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.

Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.

But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.

There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.

Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.

The factors that raise your risk of breast cancer include:

• Older age
• History of breast cancer or benign (noncancer) breast disease
• Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
• Dense breast tissue
• A reproductive history that leads to more exposure to the estrogen hormone, including
  • Menstruating at an early age
  • Being at an older age when you first gave birth or never having given birth
  • Starting menopause at a later age
• Taking hormone therapy for symptoms of menopause
• Radiation therapy to the breast or chest
• Obesity
• Drinking alcohol

The signs and symptoms of breast cancer include:

• A new lump or thickening in or near the breast or in the armpit.
• A change in the size or shape of the breast.
• A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
• A nipple turned inward into the breast.
• Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
• Scaly, red, or swollen skin in the nipple area or the breast
• Pain in any area of the breast.

Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:

• A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
• A medical history.
• Imaging tests, such as a mammogram, an ultrasound, or an MRI.
• Breast biopsy.
• Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.

If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:

• Genetic tests for genetic changes such as in the BRCA and TP53 genes.
• HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
• An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.

Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.

Treatments for breast cancer include:

• Surgery such as
  • A mastectomy, which removes the whole breast
  • A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
• Radiation therapy
• Chemotherapy
• Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
• Immunotherapy

You may be able to help prevent breast cancer by making healthy lifestyle changes such as:

• Staying at a healthy weight
• Limiting alcohol use
• Getting enough exercisee
• Limiting your exposure to estrogen by
  • Breastfeeding your babies if you can
  • Limiting hormone therapy

If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.

It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.

NIH: National Cancer Institute

Lung cancer is cancer that forms in tissues of the lung, usually in the cells that line the air passages. It is the leading cause of cancer death in both men and women.

There are two main types: small cell lung cancer and non-small cell lung cancer. These two types grow differently and are treated differently. Non-small cell lung cancer is the more common type.

Anyone can develop lung cancer, but certain factors raise your risk of getting it:

• Smoking. This is the most important risk factor for lung cancer. Tobacco smoking causes about 9 out of 10 cases of lung cancer in men and about 8 out of 10 cases of lung cancer in women. The more years you smoke and the more cigarettes you smoke each day, the more your risk goes up. Your risk is also greater if you smoke a lot and drink alcohol every day or take beta carotene supplements. If you have quit smoking, your risk will be lower than if you had kept smoking. But you will still have a higher risk than people who never smoked.
• Secondhand smoke, which is the combination of the smoke that comes from a cigarette and the smoke breathed out by a smoker. When you breathe in secondhand smoke, you are exposed to the same cancer-causing agents as smokers, although in smaller amounts.
• A family history of lung cancer.
• Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace.
• Being exposed to radiation, for example from:
  • Radiation therapy to the breast or chest
  • Radon in the home or workplace
  • Certain imaging tests such as CT scans
• HIV infection. Your risk is higher if you have HIV. However, smoking rates are higher in people who have HIV, so it's not clear whether the increased risk is from the HIV infection or from smoking.
• Air pollution. Studies show that living in areas with higher levels of air pollution increases your risk of lung cancer.

Lung cancer may not cause any signs or symptoms until the cancer is advanced. Sometimes the cancer is found during a chest x-ray done for another condition.

The symptoms of lung cancer may include:

• Chest pain or discomfort
• A cough that doesn't go away or gets worse over time
• Coughing up blood
• Trouble breathing
• Wheezing
• Hoarseness
• Loss of appetite
• Weight loss for no known reason
• Feeling very tired
• Trouble swallowing
• Swelling in the face and/or veins in the neck

To find out if you have lung cancer, your health care provider:

• Will take your medical history, which includes asking about your symptoms
• Will ask about your family history
• Will do a physical exam
• May order certain imaging tests, such as a chest x-ray or chest CT scan
• May order lab tests, including tests of your blood and sputum
• May do a procedure to take a biopsy of the lung

If you do have lung cancer, your provider will do other tests to find out if it has spread through the lungs, lymph nodes, and the rest of the body. This is called staging. Knowing the type and stage of lung cancer you have helps your provider decide what kind of treatment you need.

If you have small-cell lung cancer, your provider may also do genetic testing to look for certain gene changes (variants) in your cancer cells. The results of the testing may help guide treatment.

For most patients with lung cancer, current treatments do not cure the cancer.

Your treatment will depend on which type of lung cancer you have, how far it has spread, your overall health, and other factors. You may get more than one type of treatment.

The treatments for small cell lung cancer may include:

• Surgery.
• Chemotherapy.
• Radiation therapy.
• Immunotherapy.
• Laser therapy, which uses a laser beam to kill cancer cells.
• Endoscopic stent placement. An endoscope is a thin, tube-like instrument used to look at tissues inside the body. It may be used to put in a device called a stent. The stent helps to open an airway that has been blocked by abnormal tissue.

The treatments for non-small cell lung cancer may include:

• Surgery.
• Radiation therapy.
• Chemotherapy.
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells.
• Immunotherapy.
• Laser therapy.
• Photodynamic therapy (PDT), which uses a medicine and a certain type of laser light to kill cancer cells.
• Cryosurgery, which uses an instrument to freeze and destroy abnormal tissue.
• Electrocautery, a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue.

Avoiding the risk factors may help prevent lung cancer. For example, you can:

• Quit smoking. And if you don't smoke, don't start.
• Lower your exposure to hazardous substances at work.
• Lower your exposure to radon. Radon tests can show whether your home has high levels of radon. You can buy a test kit yourself or hire a professional to do the test.

NIH: National Cancer Institute

Cancer is a disease when the cells of the body grow out of control. Cancer screening is having tests to look for signs of cancer before you have any symptoms. By the time cancer causes symptoms, it may have already spread to other parts of your body. A screening test may help find cancer early, when it may be easier to treat.

Cancer screening only tells you whether you might have cancer. It doesn't diagnose cancer. If a screening test shows signs of cancer, you'll need to have other tests to find out if you do have cancer and how serious it may be.

Prostate cancer screening looks for signs of cancer in the prostate. The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

Prostate cancer is most common in people over age 50. It usually grows slowly and doesn't cause health problems. In fact, it's possible to live a long life with prostate cancer and never know you have it. But in certain cases, prostate cancer may spread to other parts of the body and can be very serious.

The goal of prostate cancer screening is to find prostate cancers that may be more likely to spread so they can be treated early.

Two tests are commonly used to screen for prostate cancer:

• A prostate-specific antigen test, also called a PSA blood test. PSA is a protein made by your prostate. A high level of PSA in your blood may mean you have prostate cancer, but it's not proof of cancer. That's because many other things may cause high PSA levels, including:
  • Having an enlarged prostate (benign prostatic hyperplasia or BPH)
  • Having other common prostate problems
  • Taking certain medicines
  In general, the higher your PSA, the more likely it is that you have cancer. But a low PSA blood level isn't a guarantee that you don't have cancer.
• Digital Rectal Examination (DRE). The DRE is a prostate exam. In this exam, your health care provider inserts a lubricated, gloved finger into your rectum to feel your prostate for lumps or anything unusual. A DRE can check only one side of the prostate.

A PSA test or a DRE may be able to detect prostate cancer at an early stage. But it is not clear whether early detection and treatment lower the risk of dying from prostate cancer. You should talk with your provider about the benefits and harms of prostate cancer screening.

The possible benefits of prostate cancer screening include:

• Finding and treating prostate cancer early before it spreads
• Getting a better sense of your prostate cancer risk (based on your PSA test)
• Peace of mind if your screening shows you're unlikely to have prostate cancer now
• The option to choose further testing and closely monitor your prostate if your screening shows you may have cancer

The possible harms of prostate cancer screening include:

• Getting a false positive result. This means that your PSA test shows you may have prostate cancer when you really don't. A false positive may lead to:
  • Worry while you have more tests to look for signs of cancer.
  • A prostate biopsy. In a biopsy, a doctor removes tissue from your prostate so it can be studied under a microscope to look for cancer cells. This is the only way to diagnose cancer. The possible harms of a prostate biopsy include:
    • Fever
    • Pain
    • Blood in semen
    • Urinary tract infection
• Having prostate cancer treatment that you may not have needed. Prostate cancer screening may lead to a cancer diagnosis, but it's not always clear whether the cancer is likely to grow and spread. You could have unnecessary treatment for cancer that would never have caused any health problems. And the common prostate cancer treatments may have serious, permanent complications, such as:
  • Urinary incontinence
  • Erectile dysfunction
  • Problems controlling your bowel movements (BMs)

Since there are benefits and risks to prostate screening, you should talk with your provider to decide if screening is right for you. You and your provider should consider:

• Your age. The risk of prostate cancer increases after age 50.
• Your family health history. If members of your family have had prostate cancer, your risk may be higher.
• Your race. Prostate cancer is more common in African Americans. They also have a higher risk of developing prostate cancer at a younger age and having more serious disease.
• Your general health. Are you well enough to have treatment for prostate cancer if it's found?
• What you prefer. How do you feel about the possible benefits and harms of screening, diagnosis, and treatment?

NIH: National Cancer Institute

Most women experience breast changes at some time. Your age, hormone levels, and medicines you take may cause lumps, bumps, and discharges (fluids that are not breast milk).

If you have a breast lump, pain, discharge or skin irritation, see your health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Some common breast changes are:

• Fibrocystic breast changes - lumpiness, thickening and swelling, often just before a woman's period
• Cysts - fluid-filled lumps
• Fibroadenomas - solid, round, rubbery lumps that move easily when pushed, occurring most in younger women
• Intraductal papillomas - growths similar to warts near the nipple
• Blocked milk ducts
• Milk production when a woman is not breastfeeding

NIH: National Cancer Institute

Colonoscopy and flexible sigmoidoscopy are procedures that let your doctor look inside your rectum and colon (large intestine). They use instruments called scopes. Scopes have a light and a tiny camera attached to a long, thin tube. These procedures let your doctor see problems such as inflamed tissue, ulcers, polyps, and cancer.

Colonoscopy checks your entire colon and rectum. Flexible sigmoidoscopy checks the rectum and the lower colon (sigmoid colon) only.

A virtual colonoscopy also looks inside your rectum and part of your colon. But it does not use a scope. Instead, it is an x-ray test. Another name for this test is CT colonography.

You may need a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy to find the cause of unexplained symptoms such as:

• Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
• Changes in your bowel activity, such as diarrhea
• Pain in your abdomen (belly)
• Unexplained weight loss

Doctors also use these procedures to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you are at higher risk, you may need to start getting screened for colorectal cancer earlier.

There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.

To prepare for a colonoscopy, virtual colonoscopy, or flexible sigmoidoscopy, you will need to:

• Talk with your doctor about any health problems you have and all of the medicines and supplements that you take. You may need to stop taking some of your medicines and/or supplements before the procedure.
• Follow the bowel prep instructions from your doctor. The bowel prep clears the stool out of your colon, so your doctor will be able to see the colon during the procedure:
  • You may need to follow a clear liquid diet, usually for about one day before the procedure. Avoid red or purple drinks or gelatin; the dye can look like blood in the colon. You probably need to stop eating and drinking the night before the exam.
  • You will need to take some laxatives. They may be pills, a powder that you dissolve in liquid, an enema, or a combination of these. The laxative will cause diarrhea, so you need to stay close to the bathroom.

For a virtual colonoscopy, you will also need to drink a contrast medium the night before. The contrast medium is a dye or other substance that is visible on x-rays. It can help your doctor tell the difference between stool and polyps.

For a colonoscopy:

• You will have the procedure at a hospital or outpatient center. It usually takes 30 to 60 minutes.
• You will get IV (intravenous) sedatives or anesthesia, usually along with pain medicine, so you won't be awake or feel pain during the procedure.
• You'll lie on a table while the doctor inserts a colonoscope through your anus and into your rectum and colon. The scope inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your colon.
• Once the scope reaches the opening to your small intestine, the doctor will slowly remove the scope. While doing so, your doctor will examine your colon again.
• If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
• If you have abnormal tissue, your doctor may do a biopsy.
• The sedative or anesthesia takes time to wear off completely. You'll stay at the hospital or outpatient center for 1 to 2 hours after the procedure. Then you will need someone to drive you home.

For a virtual colonoscopy:

• You will have the procedure at a hospital or outpatient center. It usually takes about 10 to 15 minutes.
• You do not need anesthesia.
• You'll lie on a table while a specially trained x-ray technician inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view.
• The table slides into a tunnel-shaped device where the technician takes the x-ray images. You will turn over on your side or stomach to get more images taken.

For a flexible sigmoidoscopy:

• You will have the procedure at a hospital, medical office, or outpatient center. It usually takes about 20 minutes.
• You do not need anesthesia.
• You'll lie on a table while the doctor inserts a thin tube through your anus and into your rectum. The tube inflates your large intestine with air for a better view. The camera sends a video image to a monitor so your doctor can see your lower colon.
• Once the scope has reached the top of the lower colon, the doctor will slowly remove the scope. While doing so, your doctor will examine your lower colon again.
• If you have polyps, your doctor may remove them and send them to a lab for testing. Most polyps aren't cancer, but removing them can prevent them from becoming cancer later on.
• If you have abnormal tissue, your doctor may do a biopsy.

You may feel cramping in your abdomen or bloating during the first hour after the any of these procedures. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.

For a virtual colonoscopy or a flexible sigmoidoscopy, you go back to your regular activities and diet right after the test. For a colonoscopy, you can expect a full recovery and return to your normal diet by the next day.

Your doctor will give you the results of your procedure. If you had a biopsy, it can take a few days to get those results.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Hodgkin lymphoma, also called Hodgkin disease, is a type of cancer that develops in the lymph system. Your lymph system is part of your immune system. It helps protect your body from infection and disease.

The lymph system is made up of tissues and organs that produce, store, and carry white blood cells. It includes your:

• Bone marrow
• Lymph nodes
• Lymphatic vessels
• Spleen
• Thymus
• Tonsils

Hodgkin lymphoma is one of the main types of lymphoma. The other is non-Hodgkin lymphoma. Each type starts in different types of white blood cells.

The cause of Hodgkin lymphoma is unknown. But there are certain people who are at higher risk of developing it.

Certain factors can make you more likely to develop Hodgkin lymphoma:

• Age. Hodgkin lymphoma is most common in early adulthood (age 20-39 years) and in late adulthood (age 65 years and older).
• Being male. The risk of adult Hodgkin lymphoma is slightly higher in males than in females.
• Past Epstein-Barr virus (EBV) infection. Having an infection with EBV as a young child or teenager increases your risk of Hodgkin lymphoma.
• A family history of Hodgkin lymphoma. Having a parent or sibling with Hodgkin lymphoma increases your risk of developing it.

The signs and symptoms of Hodgkin lymphoma may include:

• Painless, swollen lymph nodes in the neck, underarm, or groin
• Fever for no known reason
• Drenching night sweats (very heavy sweating during sleep)
• Weight loss for no known reason in the past 6 months
• Itchy skin, especially after bathing or drinking alcohol
• Fatigue

To find out if you have Hodgkin lymphoma, your provider:

• Will ask about your symptoms and medical history. This will include checking for signs of disease, such as lumps or anything else that seems unusual.
• May order some lab tests, such as:
  • Complete blood count
  • Blood chemistry studies
  • Lactate dehydrogenase (LDH) test
  • Erythrocyte sedimentation rate (ESR) test
  • Blood tests to rule out other medical conditions
  • May do imaging tests such as a CT and PET (positron emission tomography) scans
  • May do a lymph node biopsy

Treatments for Hodgkin lymphoma include:

• Chemotherapy
• Radiation therapy
• Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
• Cancer immunotherapy

Hodgkin lymphoma can usually be cured if it is found and treated early.

NIH: National Cancer Institute

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Primary liver cancer starts in the liver. Metastatic liver cancer starts somewhere else and spreads to your liver.

Risk factors for primary liver cancer include :

• Having hepatitis B or C
• Heavy alcohol use
• Having cirrhosis, or scarring of the liver
• Having hemochromatosis, an iron storage disease
• Obesity and diabetes

Symptoms can include a lump or pain on the right side of your abdomen and yellowing of the skin. However, you may not have symptoms until the cancer is advanced. This makes it harder to treat. Doctors use tests that examine the liver and the blood to diagnose liver cancer. Treatment options include surgery, radiation, chemotherapy, or liver transplantation.

NIH: National Cancer Institute

Lymphoma is a cancer of a part of the immune system called the lymph system. There are many types of lymphoma. One type is Hodgkin disease. The rest are called non-Hodgkin lymphomas.

Non-Hodgkin lymphomas begin when a type of white blood cell, called a T cell or B cell, becomes abnormal. The cell divides again and again, making more and more abnormal cells. These abnormal cells can spread to almost any other part of the body. Most of the time, doctors don't know why a person gets non-Hodgkin lymphoma. You are at increased risk if you have a weakened immune system or have certain types of infections.

Non-Hodgkin lymphoma can cause many symptoms, such as :

• Swollen, painless lymph nodes in the neck, armpits or groin
• Unexplained weight loss
• Fever
• Soaking night sweats
• Coughing, trouble breathing or chest pain
• Weakness and tiredness that don't go away
• Pain, swelling or a feeling of fullness in the abdomen

Your doctor will diagnose lymphoma with a physical exam, blood tests, a chest x-ray, and a biopsy. Treatments include chemotherapy, radiation therapy, targeted therapy, biological therapy, or therapy to remove proteins from the blood. Targeted therapy uses drugs or other substances that attack specific cancer cells with less harm to normal cells. Biologic therapy boosts your body's own ability to fight cancer. If you don't have symptoms, you may not need treatment right away. This is called watchful waiting.

NIH: National Cancer Institute