Each year, about 53,000 Americans are diagnosed with oral or oropharyngeal cancer, according to the Oral Cancer Foundation. Your dentist or doctor may find these cancers during a routine exam. Often, symptoms such as lingering mouth sores or red and white patches on the tongue, lips, or gums are the first indication something is wrong.
To determine whether these abnormalities are precancerous, cancerous, or benign, you’ll need to have an oral biopsy.
What Is Oral Biopsy?
Oral cancers are a type of head and neck cancer. They include cancer in your mouth and cancer in your oropharynx — the part of the throat that includes the tonsils, base of the tongue, and the soft palate.
If cancer is suspected, your dentist or doctor will refer you to a specialist. You will be referred to either an oral and maxillofacial surgeon or an otolaryngologist — an ear, nose, and throat (ENT) doctor. Both types of specialists are trained in medicine and surgery of the head and neck. The specialist will first conduct a thorough head and neck exam.
During an oral biopsy, the specialist removes a small amount of the suspicious tissue from your mouth or oropharynx and sends it to a pathologist, who will check for cancer cells. If cancer is confirmed, information in the pathologist’s report will help determine treatment.
Types of Oral Biopsies
There are three types of biopsies, according to the American Cancer Society. All are performed as outpatient procedures:
- Exfoliative cytology: During this in-office procedure, the doctor gently scrapes cells from the suspicious area. It’s a quick, noninvasive, and painless way to check for oral cancer, especially if the lesion or area looks only slightly suspicious. Because this method doesn’t detect all oral cancers, you may need to undergo a more invasive biopsy.
- Incisional biopsy: For this procedure, the doctor cuts out a sample of tissue for testing. Depending on the location of the suspicious tissue, an incisional biopsy can be performed either in a doctor’s office using local anesthesia or under general anesthesia in an operating room. In some cases, your doctor may have to perform an excisional biopsy, which requires cutting out most of the suspected area as well as some surrounding healthy tissue. This procedure may require stitches, which usually dissolve on their own within 10 days.
- Fine-needle aspiration (FNA) biopsy: If you have a lump in your neck, your doctor may order an FNA biopsy. During this in-office procedure, the doctor will use a very thin needle to draw out fluid or cells from the lump. The doctor numbs the affected area beforehand.
In-office oral biopsies typically don’t require any preparation. Before any biopsy, your doctor will review your health records and tell you medicines to withhold. If you’ll be having general anesthesia, the doctor also will tell you how long to fast before the procedure.
Is an Oral Biopsy Painful?
You shouldn’t feel pain during an oral biopsy. You may, however, feel a sharp pinch or pin prick from the needle used to inject the local anesthetic or the needle used to take the biopsy, according to the Radiological Society of North America. You also may feel some pressure from the instruments used to collect the sample.
Some people may experience pain after the anesthesia wears off, depending on where in the mouth or throat the sample was removed. The biopsy site may be sore for several days, which could make it difficult for you to eat solid foods. Tylenol is usually sufficient to manage the pain. Avoid taking NSAIDs, such as aspirin, Advil, or Aleve, which can increase the chance of bleeding. If you have significant pain from the biopsy, your doctor may prescribe pain medicine. Your doctor will send you home with aftercare instructions as well as a number to call if you have any questions or concerns.
To make an appointment for head and neck cancer care at UPMC Hillman Cancer Center, call 412-647-2811.