During a biopsy, a small piece of the tumour is removed to be examined under a microscope. This test provides doctors with information about the type of cell the cancer developed from. It’s used to see what type of tumour you have.

A scan (brain MRI scan or CT scan) is done to locate the tumour. Then a small hole is made in the skull and fine needle is then passed through the hole to remove a sample of the tumour. If the tumour is deep inside the brain, you may have a guided biopsy:

  • by stereotactic biopsy – you’ll be fitted with a head frame that’s used to help guide the needle to the tumour.
  • by neuronavigation – markers are placed on your head before the scan. They’re used as guides to help direct the needle to the tumour.

Having a brain tumour biopsy

You usually need a biopsy to find out the type of brain tumour you have. A biopsy is when the surgeon removes a small piece of the tumour to be examined by an expert doctor in cell types (pathologist). They can then name the type of tumour you have. Sometimes you have a biopsy during the operation to remove the tumour.

Usually you only need to stay in hospital for a few days. You will have a brain MRI scan or CT brain scan first to find the exact position of the tumour. During the biopsy, the surgeon makes a small hole in your skull. They pass a fine needle through this to remove a small piece of the tumour.

Guided biopsy

You may have a guided biopsy if the tumour is deep inside the brain. This can be done using a stereotactic biopsy or a neuronavigation biopsy.

To have a stereotactic biopsy, you need to be fitted with a head frame. The surgeon uses the frame and information from scans, which are fed into a computer, to guide the biopsy needle to the exact place. You usually have this done under a general anaesthetic, but occasionally a local anaesthetic is used.

If you have a neuronavigation biopsy, you don’t need a head frame. The surgeon uses a scan to guide the biopsy needle to the right place. Before the scan, you may have markers taped on parts of your head. These are called fiducial markers. They show up on the scan and also help the surgeon find the affected area.

Back to Surgery explained

When is surgery used?

Surgery can be used to remove all or part of the tumour or to give chemotherapy into the brain.


The surgeon removes all or as much as possible of the brain tumour with an operation called a craniotomy.


A shunt is a thin tube that drains extra fluid away from the brain to relieve raised intracranial pressure.

What happens before surgery?

To prepare for your operation, you’ll have some tests and may be given steroids. If you smoke, try to give up or cut down.

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.

What happens after surgery?

You'll be monitored closely after your operation. You may have a drip (infusion) giving you fluids for a short while.