Biopsy

[alico222]

Just a question... What re people's general thoughts re biopsy..
Has anyone had a percutaneous one.. Thru the skin lately..
Or do they consider them old hat in USA???

As my fibroscan result and bloods area at bit of a discrepancy.. My consultant has offered me one.. But I'm a bit worried about the risks with it..
Bleeding internally etc.
My platelets are currently 117.

Any input..
Should  I be worried.. Is it a good diagnostic tool??
Do I really need to do it???
One reason for doing it is to define tx... Because of the restrictions being put in uk!!!
Anyhow anybody's experiences etc welcome feedback!

[Dee1956]

Hi, I can only say that in my experience, my blood work did not match up with the amount of damage I had, this was back in 2008.  I was originally told that I had time to think about treating, based on my blood work.
Then I had a biopsy and it was discovered that I was transitioning in to cirrhosis and had to treat asap.

I did have low platelets so was worried about the biopsy but all worked out, for me.

I read WorriedMom's post and it does appear that with fibroscans doctors will soon be moving away from biopsies but even in her post one thing I noticed was this.

"Finally, the search continues for serum markers that can act as surrogates for information traditionally provided by the liver biopsy—in particular, the stage of fibrosis"

I think the stage of fibrosis is important, if you have little to no damage you can wait a bit, if you have more damage the time to treat is now.

Good luck

[Rbeth]

Hi again,

I posted earlier here, but a worried mom just shared IMHO, an important for you to read new thread tonight..." Excerpts on medscape..."  Please read this :-), informed decision is really what you wanted & deserve answer to.

Wishing you a very successful treatment & cure.
Blessings,
Randy

[Rbeth]

Hi!
I think it's completely accurate to say( I don't know percentage off hand) that there is margin for error in liver bx ( sampling sites) & margin for error in blood tests mentioned- fibrosure(I had) & fibrospect. 39%,34% miscalculation of fibrosis. I think, as said, fibroscans can be hard to come by & don't know stats.
That being said, my last percutaneous bx showed stage 0 fibrosis & my fibrosure showed F2. They were 4 years apart, however?!?

I guess I've been fortunate with Bx's. I've had three in 17 years, ALL ultra sound guided, no pain meds, numbing agent & punch & only a little cramping after two. For me @ only 95-100 lbs they were not bad at all. I'd rather sit on the beach:-) but nothing you can't do, for sure, for me!
Do they have fibrosure test in UK? If not & you required Bx to get proper Tx protocol I personally would just go do it. It has risks, but so does crossing the street, yes? You'll do well... Whatever it takes, you'll treat & that's what matters!
All blessings to you,
Randy

[Ekkiemom]

Hi Ali
Yes I had a sub Q in 2012> personally I don't think that they are that accurate as they may miss the intended spot for biopsy but fibrosure is ok,and less invasive for sure. Either way the needle biop isn't that bad in my experience.

Wishing you the best
Peace
Deb

[AWorriedMom]

At a lecture I attended last night, given by Dr Ira Jacobson, a hepatologist at Cornell, he stated that liver biopsy is no longer standard of care. He discussed that biopsy often under estimates how much fibrosis is there. He claims just as good is fibroscan, if available, or fibrosure, fibrospect, clinical exam, etc. I had trouble with my 2nd biopsy. I am Cirrhotic and I developed a very painful blood clot that took three weeks to resolve. Biopsies have a 30% sampling error. So a good doc can get a pretty good idea through the other tests and clinical exams plus lab work. People with cirrhosis often have spider nevi that a doctor can spot on the skin. They also usually have low normal or below normal platelets. That being said, if the only way you can get treatment is by doing a biopsy, imwouldnthink seriously of doing it, especially if there is concern about cirrhosis. You don't wat tomwait too long for treatment if you are cirrhotic. Wishing you the best.

[cakes8267]

I have had four biopsies over the years.  I have never had a problem but they are not fun.  Last month I had a fibroscan, what a piece of cake!  
Biopsies are outdated and fibroscan is the way to go.  I had to travel to get it done but it was well worth it.

[susan400]

I, too, have had 5 biopsies in my life.  I would get another fibroscan if they offered it anywhere near where I live.  Unfortunately, they don't and I'm on a Medicare HMO and another secondary plan. The HMO is primary and it is one of those types where if you use a place that's not on their accepted list of facilities, or doctors, you pretty much have to pay for the whole thing up front and hope they will reimburse you for a small amount.  The nearest fibroscan machine to where I live is a 6 hr round trip for a test that takes like 15 min. to do.  Not exactly cost advantageous at this point.  I am coming up on 5 yrs since my last biopsy though, and it's been 4 yrs since the one and only fibroscan I had during a clinical try (at the 6 hr round trip place).  So, for now, I'm going to have to just monitor with fibroscect blood work, MELD blood work/etc. and upper abd. ultrasounds. I hope that this will be enough and that something won't be missed. On my biopsies. ..., the 3 that I had with pain drugs-those were more tolerable than the 2 that I had with no pain drugs(except for a local)-those two were horrible.  I was given pain relief medications when i was all over with-because I was hurting so much. But, it's alot better to not hurt in the first place-which is where having a fibroscan is MUCH better option.

[otterwatcher]

yes I'm also in the UK and had a biopsy-not pleasant but you'll cope!

[flyinlynn]

I have had 5 biopsies some were better than others especially the one without pain meds because I did not have a driver and had to drive myself home.

But over all they were not terrible and I needed to have them done. I did not ever experience the internal bleeding 48 mentioned but is is one of the potential risks of the procedure.

Should  I be worried.. Is it a good diagnostic tool??

Well it isn't a party but you in all probability will be fine. It is considered the Gold Standard for staging liver disease.

Do I really need to do it???
That depends on what your treating physician feels is best for you. As you said below UK may require it.

One reason for doing it is to define tx... Because of the restrictions being put in uk!!!

I am nobody special.

If I can do it you can do it

Lynn

[48weeks]

I've had a few biopsy's and I've never had a good experience. They've always been painful and the one I had a year ago was the worst. I had internal bleeding, I was short of breath for two weeks and felt pain and discomfort. Glad I did it, but I don't plan on doing anymore.

[dontworry_behappy1]

It's my understanding that fibroscan is an exceptible way to measure liver damage.   I do think that the liver biopsy is still the gold standard in the usa.
Clearly,  the fibroscan is an economical way of assessing your liver.  Fibroscan is newly FDA approved in the usa.   It's yet to be available everywhere.   I personally have had two biopsies without any issues.  It's actually a very simple procedure.   You want to make sure you rest for a day after.   Most just go back to normal activity without issue.

Hope this is helpful