Having an abnormal finding in the bone can be scary. There are many reasons to have a lesion in your bone (a “lesion” is an unknown abnormality), and biopsy is often the only way to find out. After evaluating it by examination and some radiographic studies (X-ray, CT, MRI, etc.), it may need to be biopsied. A biopsy is a surgical procedure by which Dr. Goodman gets a piece of tissue to be studied in the lab by the pathologists (a type of doctor specializing in diagnosing disease based on the tissue)
Location and size of your lesion
Depending on the location and size of your lesion, Dr. Goodman will choose one of several types of biopsy for you, ranging from a needle sampling, to opening up your skin and bone with a drill to get to the lesion. Often, a bone “window” needs to be made to get to the lesion. Incisions for this may range anywhere from a half centimeter to two centimeters. While you are still resting in the operating room, Dr. Goodman immediately takes it to the lab and immediately consults with the pathologists. This assures that tissue obtained is indeed the abnormal tissue, and that a further biopsy should not be necessary.
After surgery you will have a small plastic covering over the area, but your entire arm or leg might be wrapped up with a bandage. This is to prevent extra bleeding or swelling. The outer bandage can be removed after 48 hours, but leave the inner plastic dressing on until you see Dr. Goodman.
Opening the bone inherently makes the bone weaker, by having a hole in it. While the pain usually goes away in a few days, the bone is still at increased risk of fracture for up to two months. If it is in your arms, you may be asked to limit the weight that you lift or any twisting motions. If it is in your legs, you may be limited to a walker or crutches, and may need a brace or a cast.
After surgery, you will return to the office as soon as Dr. Goodman and the pathologist finish the diagnosis of the tissue. This can take anywhere from 3 days to two weeks, based on the complexity. Longer wait time does not translate into a worse finding.
Please understand that Dr. Goodman never discusses results over the phone, under any circumstances. Discussions for any finding, benign (not cancer) or malignant (cancer) can be complex, and are best done face-to-face, so all questions can be appropriately addressed. After discussing the diagnosis, a treatment plan will then be made, based on the findings.
Any surgery does pose some risk, and biopsy is no exception. It is a small surgery, but still carries risks of bleeding, infection, blood clots, possible spread of tumor, medical problems and anesthetic problems. Preoperative sickness (such as diabetes, kidney disease or decreased blood flow) raises the chances of complications. Smoking is one of the biggest reasons for problems after surgery, and increases the possibility of tissues not healing appropriately.
Biopsy is the final step in the diagnosis of unknown bone lesions, and while it is natural to be nervous, it is not a scary procedure. Dr. Goodman is committed to getting you the best result possible, and looks forward to partnering with you to achieve these goals.