Pathology tests

What is a biopsy?

During a biopsy, a needle is inserted into your tissues and extracts cells for analysis. It’s used to investigate abnormal cells in areas of suspected cancer, for example a lump in the breast, and is a useful tool for diagnosing cancers.

Common types of biopsy

• Fine needle aspiration
  Fine needle aspirate, or FNA, is a quick procedure where a thin and hollow needle is inserted into a lump or mass below the surface of the skin. It can be used to remove samples of tissue or fluid
• Core biopsy
  Core biopsy is the most common type of procedure used when a larger tissue sample is needed, where a thin, hollow needle is inserted through the skin
• Ultrasound-guided biopsy
  Sometimes, your consultant may use an ultrasound scan to guide them to the precise area of abnormal tissue where the sample is to be taken from. This can also be done using other imaging techniques including X-ray (stereotactic biopsy), CT or MRI

Biopsy for prostate cancer

If you have suspected prostate cancer, you may have a prostate biopsy in order to obtain a sample of cells from your prostate for further investigation in a lab.

• Transrectal ultrasound biopsy
  A transrectal ultrasound (TRUS) biopsy is performed with your consultant using an ultrasound probe placed in the back passage to produce live images of your prostate. The needle passes through the wall of your back passage into the prostate
• Transperineal prostate biopsy
  During a transperineal prostate biopsy procedure, your consultant will use an ultrasound probe to create images of your prostate, as well as information from your previous MRI scan, to accurately guide a needle through your perineum to take samples of your prostate tissue

Biopsy for blood cancers

If you have suspected blood cancer, your consultant may take a small sample of bone marrow, usually from your pelvis (hip bone), for further analysis. Bone marrow tests are useful for diagnosing leukaemia, myeloma and lymphoma. There are two types of bone marrow test:

• Bone marrow aspirate biopsy – a small amount of bone marrow fluid is withdrawn using a needle
• Bone marrow trephine biopsy – your consultant will remove a small core of bone marrow tissue
• Find out more about bone marrow tests, including what to expect at your appointment and where we offer them.

What is a blood test?

A blood test is a collection of laboratory experiments on a sample of your blood to look for infections, analyse levels of circulating proteins, hormones and other substances, or to see if certain organs are functioning properly. 

During a colposcopy, a device called a speculum is placed within your vagina and gently opened so that your doctor can investigate abnormal cells in the cervix. It’s often performed after your results have come back from a routine cervical screening showing abnormal cells.

What is a cystoscopy?

A cystoscopy is a test where a thin camera, known as a cystoscope, is passed along your urethra to inspect the inside of the bladder. Cystoscopies are helpful for finding out the causes of bladder symptoms, can be used alongside a biopsy, or can help deliver treatment.

Types of cystoscopy

• Flexible cystoscopy – the cystoscope is bendy, and the procedure is carried out while you are awake with local anaesthetic
• Rigid cystoscopy – the cystoscope is wider and stiff, because of this, the procedure will likely be performed with you under general anaesthetic

What is genetic testing?

A genetic test involves analysing your DNA analysis to see if you are inherited any harmful genetic faults, known as mutations, which can increase your risk of certain cancers. Your doctor may recommend testing either one of your BRCA1 and BRCA2 genes if you have a family history of breast and ovarian cancer. 

What is a smear test?

A smear test helps identify any cells that are susceptible to becoming cancerous. A sterile plastic brush is used to remove cells from inside your cervix and these will then be analysed further under a microscope. 

What are urine cytology tests?

Urine cytology tests are a collection of laboratory experiments that look for abnormal cells in a sample of your urine. They’re useful for diagnosing cancers in the urinary tract such as the bladder, urethra or ureters.

What are urodynamic studies?

Urodynamic studies (UDSs) are a collection of tests which investigate how well your bladder, sphincter and urethra can hold and release urine. They’re helpful for finding out the causes for a range of bladder symptoms and can to help diagnose an enlarged prostate. These kinds of tests can be called a bladder scan or urinary flow analysis.