What to Expect:

A lymph node biopsy is performed in an operating room in a hospital. Or, it is done at an outpatient surgical center. The biopsy may be done in different ways.

An open biopsy is surgery to remove all or part of the lymph node:

• You lie on the examination table. You may be given medicine to calm you and make you sleepy.
• The biopsy site is cleansed.
• The health care provider injects a local anesthetic (numbing medicine) into the area. Sometimes, general anesthesia is used, which means you are asleep and pain-free.
• A small surgical cut (incision) is made. The lymph node or part of the node is removed.
• The incision is closed with stitches and a bandage is applied.
• An open biopsy may take 30 to 45 minutes.

For some cancers, a special way of finding the best lymph node to biopsy is used. This is called sentinel lymph node biopsy, and it involves:

• A tiny amount of a tracer, either a radioactive tracer (radioisotope) or a blue dye, is injected at the tumor site.
• The tracer or dye flows into the nearest (local) node. This node is called the sentinel node. It is the first lymph node to which a cancer spreads.
• The sentinel node and possibly one or two other lymph nodes are removed.

Lymph node biopsies in the belly may be done with a laparoscope. This is a small tube with a light and camera that is inserted through a small incision in the abdomen. The lymph node is located and a piece of it is removed. This is usually performed under general anesthesia, which means the person having this procedure will be asleep and pain-free.

After the sample is removed, it is sent to the laboratory for examination.

A needle biopsy involves inserting a needle into a lymph node. This type of biopsy is done less often because the results are not as helpful as with an open biopsy.