Ultrasound Guided Biopsy in Sharjah

What is an ultrasound-guided biopsy?

An ultrasound-guided biopsy is a way of taking a small sample from a lump or abnormal area through a needle, while watching the needle on an ultrasound screen. Seeing the needle tip in real time lets the radiologist place it precisely in the part of the lump that needs testing, through a skin puncture a few millimetres wide.

There are two main types. A fine needle aspiration, often called FNA, uses a very thin needle to draw out cells. A core needle biopsy uses a slightly larger needle to take thin strips of tissue, which show how the cells are arranged as well as what they are. Your radiologist chooses the type that best answers the question about your lump.

At Dar Al Kamal Hospital, Sharjah, ultrasound-guided biopsies are performed by radiologists in the Radiology department. The samples are sent to the laboratory, and the result goes to the doctor who requested the biopsy.

Who needs it

An ultrasound-guided biopsy is arranged when imaging has found a lump or area whose nature can only be confirmed by looking at cells or tissue under a microscope. Common reasons include:

• A breast lump or an area found on a mammogram or breast ultrasound that needs a closer look
• A thyroid nodule with features on ultrasound that call for sampling
• An enlarged lymph node in the neck or armpit
• A soft-tissue lump under the skin or in a muscle
• Some areas in the liver or other organs that ultrasound can reach safely

Thyroid nodules are a common finding in the UAE, often picked up by chance on a neck scan done for another reason. Most are harmless, and a biopsy is advised only for nodules with particular size or appearance features, so many people with a nodule simply have it watched with repeat ultrasound scans.

The biopsy is arranged by your treating doctor, who is often a breast or general surgeon in General and Laparoscopic Surgery, an ENT surgeon in Otolaryngology (E.N.T) for thyroid and neck lumps, or your family doctor. The same ultrasound guidance can also be used to drain a fluid collection when your treating doctor requests it.

What happens

You lie on a couch in a position that gives the clearest view of the lump. The radiologist first scans the area to plan the safest path for the needle, then cleans the skin with antiseptic.

Local anaesthetic is injected into the skin and the tissue around the lump. This stings briefly, then the area goes numb. You stay awake throughout.

With the ultrasound probe held over the lump, the radiologist guides the needle in and takes the sample:

1. For a fine needle aspiration, the needle is moved gently in and out for a few seconds to collect cells.
2. For a core needle biopsy, a spring-loaded device takes each tissue strip. It makes a loud click when it fires, which can be startling, so the radiologist usually lets you hear it before the first sample.
3. Several samples are usually taken, so the laboratory has enough material to give a clear answer.

For a breast biopsy, a tiny marker clip may be placed at the biopsy site. The clip is safe to leave in the body and lets doctors find the exact spot on future mammograms or during surgery.

When sampling is complete, firm pressure is applied for several minutes to reduce bruising, and a small dressing is put on. The whole procedure is usually brief, with most of the time spent on positioning and planning.

Preparing for it

• Tell the team about blood-thinning medicines well before the biopsy date, including tablets taken for the heart, a previous stroke or clots. Do not stop any of these medicines unless the doctor who prescribed them has advised you to.
• Mention any allergies, especially to local anaesthetic, antiseptic or dressings.
• Eat and drink normally unless you are told otherwise.
• Wear a two-piece outfit so only the area being sampled needs to be uncovered. For a breast biopsy, a soft supportive bra is comfortable afterwards.
• Bring previous scans and reports, since the radiologist compares them with today's images.
• Arrange a lift home if you can, particularly after a breast or neck biopsy, since the area can feel sore.

Afterwards

Most people return to normal daily activities the same day. Avoid heavy lifting and strenuous exercise with the affected arm or area for a day or so, and keep the dressing dry as advised. Bruising, mild swelling and tenderness around the biopsy site are common and fade gradually. Simple pain relief of the kind you normally use is usually enough.

The samples are examined in the laboratory, and a report is sent to the doctor who requested the biopsy. That doctor explains the result together with your scans and plans any next step.

Contact the hospital if swelling around the biopsy site keeps increasing, if bleeding continues after you have pressed on the dressing firmly for ten minutes, or if you develop a fever, spreading redness or warmth around the site. After a neck biopsy, seek urgent help straight away if a swelling in the neck grows quickly or you have difficulty breathing or swallowing.

Cost and insurance

Most UAE health insurance plans cover an ultrasound-guided biopsy when a doctor requests it to investigate a lump, but pre-approval is usually needed for both the procedure and the laboratory analysis of the samples. Starting the approval as soon as the biopsy is advised helps avoid delay. Dar Al Kamal Hospital, Sharjah can help you confirm your cover on 06 599 7777.