A lung cancer biopsy is a key step in reaching an accurate diagnosis and planning the most effective treatment. For many patients, the word biopsy sounds intimidating — but in reality, most biopsies are routine, carefully planned procedures performed safely every day across the UK.
In this article, Dr Dionysis Papadatos-Pastos, consultant medical oncologist specialising in thoracic cancers in London, explains what a lung cancer biopsy is, the different types available, how the procedure works, potential risks, and what patients should realistically expect before and after the test.
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Topics CoveredWhat Is a Lung Cancer Biopsy?
A lung cancer biopsy is a procedure used to remove a small sample of tissue or cells from the lung or nearby lymph nodes. This sample is examined under a microscope by a specialist pathologist.
A biopsy allows doctors to:
- Confirm whether a lung abnormality is cancerous
- Identify the exact type of lung cancer
- Perform molecular and genetic testing
- Guide personalised treatment decisions
Imaging scans alone cannot provide this level of detail.
Why a Biopsy Is So Important in Lung Cancer
Modern lung cancer treatment depends heavily on precise diagnosis. A biopsy is essential because it helps determine:
- Cancer type (non-small cell vs small cell)
- Tumour subtype (adenocarcinoma, squamous, etc.)
- Molecular features (EGFR, ALK, KRAS and others)
- Eligibility for targeted therapy or immunotherapy
Without a biopsy, treatment decisions may be less accurate or incomplete.
Types of Lung Cancer Biopsies
The choice of biopsy depends on tumour location, size, patient health, and imaging findings.
Bronchoscopy Biopsy
A thin, flexible tube is passed through the mouth or nose into the airways.
- Often used for centrally located tumours
- Usually performed with sedation
- Minimally invasive
CT-Guided Needle Biopsy
A needle is inserted through the chest wall using CT imaging for guidance.
- Common for peripheral lung nodules
- Performed under local anaesthetic
- Short recovery time
Endobronchial Ultrasound (EBUS)
An advanced bronchoscopy technique using ultrasound to sample lymph nodes.
- Essential for staging lung cancer
- Minimally invasive
- High diagnostic accuracy
Surgical Biopsy
In selected cases, surgery may be required to obtain tissue.
- Performed under general anaesthetic
- Usually when less invasive methods are not suitable
- Provides larger tissue samples
What Happens During a Lung Cancer Biopsy?
Although techniques differ, most biopsies follow a similar process.
Before the Procedure
Patients may:
- Have blood tests
- Be advised to stop certain medications (such as blood thinners)
- Receive instructions about eating and drinking
The medical team explains the procedure and answers questions beforehand.
During the Biopsy
- The area is numbed with local anaesthetic or sedation
- Imaging or endoscopic guidance is used for precision
- The procedure usually lasts 20–60 minutes
Most patients experience minimal discomfort.
After the Biopsy
- Short monitoring period
- Chest X-ray may be performed (for needle biopsies)
- Most patients go home the same day
Risks and Safety of Lung Cancer Biopsies
Lung biopsies are generally safe, but like all medical procedures, they carry some risks.
Possible risks include:
- Mild bleeding
- Temporary shortness of breath
- Pneumothorax (collapsed lung), usually small and treatable
Serious complications are uncommon, particularly when biopsies are performed by experienced teams.
Does a Biopsy Spread Cancer?
This is a common concern among patients.
There is no evidence that lung cancer biopsies cause cancer to spread. The benefits of obtaining accurate diagnostic information far outweigh this theoretical risk.
How Long Do Biopsy Results Take?
Initial pathology results are often available within:
- 3–7 days
Molecular and genetic testing may take:
- 1–2 weeks
Your oncology team will explain when results are expected and arrange a follow-up discussion.
How Biopsy Results Guide Treatment
Biopsy results help determine:
- Whether surgery is appropriate
- If chemotherapy is needed
- Eligibility for targeted therapies
- Suitability for immunotherapy
This personalised approach has transformed lung cancer outcomes in recent years.
Emotional Impact of Waiting for Results
Waiting for biopsy results can be stressful. This period of uncertainty is completely normal.
Patients are encouraged to:
- Ask questions
- Seek support from family or healthcare professionals
- Avoid relying on unverified online sources
Clear communication is a key part of high-quality cancer care.
Support and Follow-Up Care
Dr Papadatos-Pastos and his team provide ongoing support beyond medical treatment.
Patients receive clear communication, psychological care and access to nutrition, physiotherapy and symptom-management services.
Regular follow-up ensures early detection of recurrence and long-term wellbeing.
Book a Consultation
If you or someone close to you has been diagnosed with lung cancer, early consultation with a specialist can make a real difference. Appointments are available at several London clinics.
Faq
Answers to Common Questions
Clear answers to questions patients and families often ask about lung cancer biopsies.
Most patients report mild discomfort rather than pain. Local anaesthetic and sedation are used to ensure comfort.
Many biopsies are done while awake with sedation. Some procedures require general anaesthetic.
Yes. Most lung cancer biopsies are day-case procedures.
Occasionally, a repeat biopsy or a different technique may be needed to obtain enough tissue.
In most cases, yes. A biopsy is essential for accurate diagnosis and personalised treatment planning.
