Does general surgery do biopsies? The definitive guide

October 2, 2025 •

4 min read

According to the National Cancer Institute, a biopsy is the removal of cells or tissues for examination by a pathologist to determine if a condition is cancerous or benign.

So, does general surgery do biopsies? The answer is a clear and resounding yes, as they are equipped to perform a wide range of these diagnostic procedures.

Quick Summary

General surgeons routinely perform biopsies, especially surgical ones, to diagnose conditions by removing tissue for laboratory analysis.

They are often involved when a more invasive procedure than a needle biopsy is required, removing suspicious lumps or lesions entirely or in part.

Key Points

General Surgeon's Role: General surgeons are trained to perform biopsies, especially those that require a more invasive, surgical approach like excisional or incisional biopsies.
Surgical Biopsy is Common: When a suspicious area is large, deep, or potentially malignant, a general surgeon is often the specialist who removes the tissue sample for diagnosis.
Variety of Procedures: General surgeons handle various types of biopsies, including complete removal of a lesion (excisional) or sampling a portion of a larger mass (incisional).
Complementary to Other Methods: Surgical biopsies are often performed when less invasive methods, such as fine-needle or core needle biopsies, are inconclusive or not feasible.
Pathology Collaboration: A critical part of the process involves the close collaboration between the general surgeon and a pathologist to ensure an accurate and definitive diagnosis.
Diagnostic and Therapeutic: An excisional biopsy performed by a general surgeon can serve both as a diagnostic tool and a primary form of treatment, removing the entire problem area.

The Role of General Surgeons in Biopsy Procedures

General surgeons play a vital role in the diagnostic process by performing biopsies when initial screenings or imaging tests reveal a suspicious area that requires further examination.

While many types of biopsies are minimally invasive and can be performed by other specialists, the expertise of a general surgeon becomes crucial for more complex or invasive procedures. Their broad knowledge of the human body, including the abdomen, breasts, endocrine system, and more, makes them uniquely qualified to handle biopsies of various types and locations.

Types of Biopsies Performed by General Surgeons

Not all biopsies are the same, and the method used depends on the location and nature of the tissue being examined.

General surgeons are skilled in several types:

Excisional Biopsy: The surgeon removes the entire suspicious lump, lesion, or tumor, along with a small margin of surrounding healthy tissue. This is a definitive diagnostic and often therapeutic procedure, meaning it both provides a diagnosis and removes the problem.
Incisional Biopsy: When a lump or suspicious area is too large to be removed completely, a general surgeon will remove only a portion of the tissue for analysis. This is a common approach for large soft tissue masses or tumors, and the results help determine the best course of future treatment.
Open Biopsy: This procedure involves making a larger incision to access a deeper, more difficult-to-reach area to remove tissue. Open biopsies are a more invasive form of surgical biopsy and require general anesthesia.
Image-Guided Core Needle Biopsy: In some cases, a general surgeon may perform a core needle biopsy guided by imaging like ultrasound, especially for palpable masses. However, this is more commonly done by interventional radiologists.

When is a General Surgeon Needed for a Biopsy?

A referral to a general surgeon for a biopsy is typically made when:

Needle biopsies are inconclusive: If a less invasive needle biopsy doesn't provide enough information or is non-diagnostic, a surgical biopsy may be necessary.
A lesion is large or difficult to access: Deep-seated masses, or those located near vital structures, may require surgical expertise for safe and complete removal.
Imaging suggests a high probability of malignancy: When a doctor's suspicion of cancer is high, an excisional biopsy by a surgeon can provide both a diagnosis and initial treatment.
It is part of a larger surgical plan: If a patient is already undergoing surgery for another reason, a general surgeon may perform a biopsy at the same time to avoid a second procedure.

Biopsy Procedure Overview: What to Expect

Understanding the general process can help ease anxiety for patients facing a biopsy.

Consultation: The surgeon will discuss your medical history, perform a physical exam, and explain the recommended biopsy procedure, including risks and benefits.
Preparation: You will receive specific instructions, which may include fasting or adjusting medications before the procedure.
The Procedure: Depending on the type of biopsy, it will be performed under local or general anesthesia. The surgeon will remove the tissue sample and close the incision with stitches or staples.
Recovery: Recovery time varies based on the procedure's invasiveness. You will receive post-operative care instructions covering wound care, pain management, and activity restrictions.
Pathology: The tissue sample is sent to a pathology lab where it is analyzed by a pathologist. This expert determines if the tissue is benign or malignant and provides a report to your doctor.
Follow-up: Your doctor will schedule a follow-up to discuss the biopsy results and determine the next steps, if any.

Comparison of Common Biopsy Types


Feature	Excisional Biopsy	Incisional Biopsy	Fine-Needle Aspiration (FNA)	Core Needle Biopsy
Surgical Incision	Yes	Yes	No	No
Anesthesia	General or Local	General or Local	Local only	Local only
Sample Size	Entire lesion + margin	Part of lesion	Cells/fluid only	Small tissue cores
Performed By	General Surgeon	General Surgeon	Pathologist or Radiologist	Radiologist or Surgeon
Invasiveness	High	Medium	Low	Low
Time to Results	Same as other biopsies	Same as other biopsies	Often quicker	Standard
Benefit	Diagnostic and therapeutic	Minimizes invasiveness	Fast, least invasive	Larger sample than FNA

The Critical Role of Pathology

Once a general surgeon removes a tissue sample, it's sent to a pathologist for microscopic examination.

This is a critical step, as the pathologist's report provides the definitive diagnosis. General surgeons and pathologists work closely together to ensure the tissue is handled and analyzed correctly. For instance, the surgeon may need to provide details on the location and orientation of the removed specimen to help the pathologist interpret the findings accurately.

Why the General Surgeon-Pathologist Partnership is Important

Accuracy: Proper communication ensures the pathologist understands the clinical context, leading to a more precise diagnosis.
Treatment Planning: The pathologist's report guides the surgeon and other specialists in formulating an effective treatment plan, especially for cancer cases.
Patient Outcome: A correct and timely diagnosis, resulting from this collaborative effort, is crucial for achieving the best possible outcome for the patient.

Conclusion

Yes, general surgeons absolutely perform biopsies. Their expertise is especially critical for surgical biopsies, where a deeper or more complete removal of suspicious tissue is required for accurate diagnosis and treatment. These procedures, including excisional and incisional biopsies, are a fundamental part of a general surgeon's practice. By working closely with pathologists, they ensure patients receive the correct diagnosis and a clear path forward. If you have concerns about a suspicious lump or lesion, your primary care provider may refer you to a general surgeon for a biopsy. This is a common and necessary step toward understanding and managing your health.

For more authoritative information on different types of biopsies, you can visit the Mayo Clinic's detailed resource on the topic.

Frequently Asked Questions

A radiologist typically performs minimally invasive, image-guided biopsies, such as fine-needle aspirations or core needle biopsies. A general surgeon is usually involved when a more invasive, surgical procedure is necessary, like an incisional or excisional biopsy, which involves a larger incision.

General surgeons have a broad scope, performing biopsies on the breast, abdomen, skin, and lymph nodes. However, for specialized areas like the prostate, brain, or bone marrow, other specialists like urologists, neurosurgeons, or hematologists would be involved.

No, a biopsy is a diagnostic tool used to investigate any suspicious tissue, not just cancer. It can also be used to diagnose non-cancerous conditions such as infections, inflammatory disorders, or benign tumors.

The type of anesthesia depends on the complexity and location of the biopsy. For simpler procedures, a local anesthetic is sufficient. For more extensive surgical biopsies, general anesthesia is often required.

The tissue is sent to a lab for analysis by a pathologist. While some preliminary results can be available quickly, a comprehensive pathology report typically takes several days to a week. Your doctor will discuss the timeline with you.

While uncommon, an inconclusive biopsy might happen if the sample isn't sufficient for a definitive diagnosis. In such a case, your general surgeon will discuss alternative diagnostic approaches, which may include another biopsy or further imaging.

Any surgical procedure involving an incision will result in some scarring. A general surgeon will take care to minimize scarring, but the size of the incision will depend on the biopsy type and the location of the tissue being removed.