Needle Biopsy: Understanding Side Effects, Costs, and Testing Time

During health checks or imaging tests, if abnormalities or lumps are detected, doctors may recommend a needle or tissue biopsy. This is a common diagnostic procedure which involves tissue sampling to help doctors with diagnosing the nature of the condition, such as cancer, infection, or other diseases. Needle biopsies not only enhance diagnostic accuracy but are also crucial for treatment planning. This blog provides a comprehensive overview of needle biopsy types, procedures, common sites, costs, and care considerations to give you a better understanding of this procedure.

Why are Biopsies Necessary?

A biopsy serves to establish the reason behind a mutation. While many people tend to associate needle biopsies with cancer, since the majority of biopsies are performed to distinguish between benign and malignant tumours, needle biopsies can also be conducted to diagnose other conditions (such as inflammation, infection, and immune system diseases). It is crucial for medical practitioners to identify the cause before developing a treatment plan.

How are Needle Biopsies Performed?

The steps of a needle biopsy are as follows:

Explain the procedure to the patient, why it is necessary, the possible side effects and complications and get an informed, signed consent.
Prepare the skin with antiseptics (if going through or piercing the skin) or bowel preparation for gut-associated biopsies via endoscopes.
Administer local, regional, conscious sedation or general anaesthesia.
Direct the needle point to the tumour, usually with ultrasound, x-ray (via mammograms), CT scan or MRI guidance or resecting all/ part of the affected tissue or using an endoscope tissue forceps or snare to extract tissues or cells from hollow organs like the gut, airways and urinary bladder.
Place the samples in a preservative solution, like formalin, and send to a laboratory for analysis.

Various Types of Needle Biopsies

The following are some common types of needle biopsies:

1. Fine Needle Aspiration (FNA)

Extracting cell samples using a small bore, fine-tipped needle.

2. Core needle Biopsy

Extracting tissue with a bigger or larger bore needle.

3. Bone marrow Aspiration and Biopsy

Extracting bone marrow fluid and tissue from the pelvic region with a large bore needle. Used for the diagnosis of blood disorders such as leukaemia and lymphoma.

4. Endoscopic Biopsy

Inserting an endoscope equipped with cytology brushes, forceps or snares into internal organs (such as the bladder, intestines and lungs) for the extraction of tissues that pose potential health risk.

5. Incisional Biopsy

Surgical removal of a portion or part of the affected tissue or tumour.

6. Excisional Biopsy

Surgical removal of the entire affected tissue or tumour.

7. Punch Biopsy

Extracting a small sample of deep skin tissue using a cylindrical tool.

8. Frozen Section Biopsy

Done during surgery wherein a tissue sample is rapidly frozen using liquid nitrogen or a cryostat and processed for immediate microscopic examination while the surgical team waits for the result. Usually done for margin clearance in cancer surgery or to determine a benign or malignant tumour while in the operating room.

Common Organs for Needle Biopsies

Breast

Prostate

Endometrial

Liver

Heart (especially for those who have undergone heart transplant surgery)

Kidney (especially for post-transplant patients and some acute kidney conditions)

Skin

Thyroid

Bone marrow
Muscle

Frequently Asked Questions

1. How much does a needle biopsy cost?

In public hospitals in Hong Kong, starting January 1, 2026, the cost for inpatients (including pathology testing services) ranges from HKD $200 to $300, while outpatient pathology testing services range from $50 to $200. Private hospitals charge based on the size of the sample, with outpatient needle biopsy costs ranging from HKD $1,660 to $6,100. Cost considerations may also include hospitalisation, operating theatre, instrumentation (e.g. endoscopes) and managed anaesthesia care. It is recommended to inquire with the relevant medical institutions for more details.

2. What are the side effects of a needle biopsy?

Most needle biopsies are low-risk procedures. Common side effects include mild pain and slight bleeding at the biopsy site. Less common but noteworthy complications include infection, fever, persistent bleeding at the biopsy site, swelling, or leakage at the biopsy location. If any of these symptoms occur, please contact your primary physician as soon as possible. Tumour seeding along the needle track is also a possibility but rare occurrence.

3. What care is needed after a needle biopsy?

If you undergo a needle biopsy with local anaesthesia, you can usually go home the same day. If there are stitches or dressings at the biopsy site, healthcare personnel will guide you on how to care for the wound at home. If necessary, the doctor may prescribe pain relief medication.

4. How long does it take to get test results?

Generally, test reports take a few days to over a week.

Summary

Needle biopsy is a common diagnostic procedure used when abnormalities are found during health checks or imaging. Please feel free to consult our doctors to further discuss your concerns.