Biopsy for ovarian cancer
You may have a biopsy to help diagnose cancer of the ovary, fallopian tube or peritoneum. A doctor removes a small sample from the lump or abnormal area.
What is a biopsy?
A biopsy is a sample of cells or tissue. A doctor at a laboratory will look at the sample under a microscope. If it contains cancer cells, the doctor should be able to:
- tell the type of ovarian cancer
- tell the grade of cancer
- use the sample for genetic testing.
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When is a biopsy done?
If your ultrasound scan or blood tests results are not typical of ovarian cancer, you may have a biopsy first. This is so your doctors can be sure of the diagnosis before surgery.
If your first treatment is surgery, you will have biopsies taken during the operation. If your doctor thinks you need chemotherapy first, you usually have a biopsy before treatment.
How is an ovarian biopsy done?
Image-guided fine needle biopsy
A radiologist or nurse passes a fine needle through the skin. They use a CT or ultrasound to guide them. They will numb the skin in that area with an injection of local anaesthetic. They may also give you a sedative to help you relax.
Sometimes they take a biopsy through the vagina, using an ultrasound scan to guide them.
They remove a small sample of tissues or cells from the abnormal area with the needle.
Laparoscopy
A laparoscopy is a small operation that allows doctors to look at the ovaries and other organs in the pelvis. You have a laparoscopy under general anaesthetic. This means you will have a short stay in hospital.
The surgeon makes a small cut (incision) near the belly button. They then insert a thin tube into the tummy. This tube is called a laparoscope. It has a tiny camera and light on the end. This allows doctors to look at the ovaries and surrounding tissues.
To make it easier to see, the doctor will pump gas into the tummy. The gas can cause uncomfortable wind and shoulder pains for several days afterwards. Walking around or sipping peppermint water can help give you relief. After the laparoscopy, you will have 1 or 2 stitches in your tummy.
A doctor may take a biopsy during a laparoscopy.
Laparotomy
If a laparoscopy is not suitable for you, a surgeon may do a laparotomy.
A laparotomy is an operation to look inside the pelvic area. It happens under general anaesthetic. The surgeon makes a larger cut in the tummy so they can see the ovaries and other organs. They may do this to get a biopsy, but usually the aim of a laparotomy is to remove all the cancer.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our ovarian cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Ovarian cancer: recognition and initial management. Clinical guideline [CG122] Published: 27 April 2011 Last updated: 02 October 2023 www.nice.org.uk/guidance/cg122 (accessed May 2024)
Ovarian cancer: identifying and managing familial and genetic risk. NICE guideline [NG241]. Published: 21 March 2024 www.nice.org.uk/guidance/ng241 (accessed May 2024)
A. González-Martín, P. Harter, A. Leary, D. Lorusso, R. E. Miller, B. Pothuri, I. Ray-Coquard, D. S. P. Tan, E. Bellet, A. Oaknin & J. A. Ledermann, on behalf of the ESMO Guidelines Committee. Newly diagnosed and relapsed epithelial ovarian cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Published August 17, 2023. www.annalsofoncology.org/article/S0923-7534(23)00797-4/fulltext (accessed May 2024)
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