Biopsy of the Mouth and Throat

A biopsy is a minimally invasive procedure during which a doctor takes a small sample of suspicious cells. A pathologist examines the tissue sample under a microscope and determines whether the cells are normal or cancerous.

We use the least invasive biopsy procedure possible, minimizing discomfort while still obtaining enough cells to make a diagnosis.

We specialize in image-guided biopsy, which uses one of our imaging technologies to precisely locate the area where we need to take the tissue sample. We offer several types of oropharyngeal biopsy, and you may need one or more types depending on your individual case.

• Needle biopsy: The doctor inserts a needle into the tumor to remove a tiny sample of cells from a suspicious area. There are two types:
  • Fine-needle aspiration biopsy uses a very thin needle and syringe. You may or may not need a local anesthetic (numbing medicine) for this procedure.
  • Core biopsy uses a wider needle to take the sample. Your doctor will give you a local anesthetic to numb your skin for the procedure. This is the biopsy procedure we use most often to confirm a diagnosis of cancer.
• Image-guided biopsy: Our radiologists often use imaging to precisely locate the abnormal tissue and guide the needle for the sample. Types of imaging for guided biopsy include:
  • MRI-guided biopsy: This biopsy uses radio waves and a magnetic field.
  • Ultrasound-guided biopsy: This biopsy uses high-frequency sound waves.
• Endoscopy: In this procedure, a long, flexible tube with a small camera (endoscope) is inserted down your throat and esophagus and into your stomach and upper small intestine (duodenum). With the endoscope, your doctor can view your esophagus for irregularities and remove tissue samples for biopsy and culture.
• Surgical biopsy: In some situations, a surgeon may remove part of a tumor for testing, or all of it. The goal is to determine whether the tumor is benign (noncancerous) or malignant (cancerous).

Pathology: Analyzing biopsies

After you have a biopsy, your nurse sends your tissue samples to our pathologists for review. A pathologist is a medical doctor who specializes in reviewing and evaluating lab tests, cells, and tissues to diagnose disease. Our pathologists analyze biopsy samples to determine whether the tissue is cancerous and, if so, what type of oropharyngeal cancer it is.

At Stanford, our pathologists specialize in oropharyngeal cancer. That focus means they have extensive expertise interpreting oropharyngeal biopsies and other tests to confirm or rule out an oropharyngeal cancer diagnosis.

Because oropharyngeal cancer represents a complex group of different diseases, it’s important to have expert pathologists on your care team. Years of experience studying oropharyngeal cancer every day means your pathologist can accurately identify critical details. This information includes whether the cancer:

• Is invasive or noninvasive
• Shows a high or low cell grade (rating that describes how different the cancer cells are from normal cells)
• Is aggressive or slow growing
• Contains specific molecules that indicate the cancer subtype

All these details help form an accurate diagnosis, which is vital to your treatment plan. Your care team takes the time to do a thorough evaluation from the start, so that your treatment will be more effective.

Oropharyngeal tumor tissue bank

Our doctors and researchers work to thoroughly understand the true diversity of oropharyngeal cancer and identify the genetic abnormalities that can play a role in oropharyngeal cancer formation. That’s why it’s critical that our doctors have access to tissue samples to plan for each patient’s care.

At Stanford, we store oropharyngeal tissue samples, so we can use them for research, using the following process:

1. After we take a biopsy (tiny sample of oropharyngeal tissue), we ask you if you would like to give it to the tissue bank.
2. The tissue first goes to the laboratory, where the pathologist samples it.
3. If you approve, the tissue then goes to oropharyngeal cancer research specialists. These doctors work with our clinicians (doctors involved in patient care) to identify new pathways of tumor formation and possible treatments.
4. The data is made anonymous and is not available to you after donation, because we use it for research and not for clinical use in making treatment decisions.

Our oropharyngeal tumor tissue bank provides our doctors and other researchers with a variety of different types of oropharyngeal cancer cells to study. As we work on new methods and tools for diagnosing and treating oropharyngeal cancer, our goal is to move these findings from the lab into patient care.

Current as of: 1/2020