NSCLC

Biopsy for lung cancer

Biopsies for lung cancer

After you have visited your doctor with some symptoms that you were worried about, they will have initially carried out some tests to check inside your lungs (for example, an X-ray or a scan – you can read more about these here)

While these scans can suggest whether someone has cancer or not, the diagnosis of cancer can only be confirmed after a test called a biopsy.1

A biopsy is a test where a small piece of the cancer is removed from your body, or cancer cells are collected from your blood or any mucus you cough up. Then, various tests are carried out on the piece of cancer to determine what kind of cancer it is, and what treatments are likely to be most successful at treating it.

There are a few different kinds of biopsies. The one you get will depend on where in your lungs the cancer is growing. 2 The information below will give you an idea about how a biopsy is collected and tested. Each clinic is different though, so you may have a slightly different experience to the information here. 

When you arrive, a member of the healthcare team will talk you through exactly what to expect.

The technician and doctor taking your biopsy sample will offer you anaesthesia (numbing medicine), or maybe a sedative (a medicine to make you feel sleepy) if you can have these to help make sure you are as comfortable as possible throughout the biopsy process.

Some types of biopsies are described below – these might sound a little scary, but remember that you’ll be given medicines and lots of support to help you feel as comfortable and relaxed as possible:2

  • Transthoracic biopsy: a needle is pushed from outside the body, through the chest, and into the tumour to remove some of the cancer for testing
  • Thoracentesis: a needle is inserted, but this time it is used to collect fluid from around the lungs to analyse any cancer cells that may have leaked into this area
  • Transtracheal or transbronchial biopsy: a tube is passed down the windpipe, and a needle is pushed through the windpipe into the lungs to take a piece of the cancer

Not all tests that confirm cancer are done with a needle. These include:2

  • Bronchial brushing and washing: a doctor passes a tube down the windpipe and then either uses a small brush to scrape away some tumour cells for testing, or washes the tumour with a saltwater solution to collect the cells
  • Sputum cytology: a sample of any mucus that you cough up (known as sputum) can be analysed to see if there are any cancer cells and test these

Sometimes performing tests like the ones described above can be difficult. In these cases, the doctor might offer a blood-based test that looks for evidence of any cancer in a blood sample.3

The sample of your blood or lung from the biopsy is sent to a specialist laboratory that will closely analyse the results.In some cases, the biopsy may not have contained enough cells or DNA to get a good result. If this happens, then another biopsy may be needed.4 It may be the same type of biopsy as before, or a different one.

If the laboratory was able to get results from the biopsy, they will send these back to the doctor, who will discuss them with you and talk about what the next treatment steps are. 


NSCLCNon-small cell lung cancer

  1. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guideline in Oncology: Non-Small Cell Lung Cancer, Version v1 2022.
  2. American Cancer Society. Tests for Non-Small Cell Lung Cancer, 2017. Available from: https://www.cancer.org/cancer/non-small-cell-lung-cancer/detection-diagnosis-staging/how-diagnosed.html. Last accessed August 2021.
  3. Foundation Medicine. FOUNDATIONONE®LIQUID. Available from: https://www.foundationmedicine.com/genomic-testing/foundation-one-liquid. Last accessed August 2021.
  4. Ofiara LM et al. Curr Oncol 2012; 19(Suppl 1): S16–S23.