An open biopsy is a procedure in which a surgical incision is made through the skin to expose and remove a piece of the tumor to be analyzed. The biopsy tissue is examined under a microscope by a pathologist. An open biopsy may be done in the doctor's office or hospital, and may use local anesthesia or general anesthesia.
An Open Biopsy requires that the patient be brought to the operating room and the skin is cut (incision is made) over the tumor. A piece of tumor is cut out and sent to the pathologist to be studied under the microscope. An open biopsy requires the skin to heal postoperatively before starting any treatment. This is different from a core needle biopsy in which there is no healing time. There are also more complications such as infection, hematoma and fracture associated with an open biopsy. The risk of a local recurrence (the tumor coming back after it is surgically removed) is also higher following an open biopsy than with a core needle-biopsy.
The diagnostic accuracy rate of a core needle biopsy is the same or better than an open biopsy when performed at a center experienced with the treatment of these tumors (experienced orthopedic oncologist, musculoskeletal radiologist and surgical pathologist). About 90% of tumors are diagnosed accurately with this method. I therefore prefer core needle biopsy over an open biopsy for bone and muscle tumors (sarcomas of bone and soft tissues) because of its greater diagnostic accuracy and because it is associated with fewer complications. Open biopsies are usually reserved for unusual circumstances or when a diagnosis can not be rendered by a core needle biopsy (if more biopsy material will help make a diagnosis).