Imaging tests are important
in diagnosing suspected pancreatic cancer, but they cannot determine with
100% certainty if an abnormal mass is cancer or the type of cancer. The
doctor must obtain and analyze a tissue sample, or biopsy, of the tumor
in order to determine the exact diagnosis. During a biopsy, a pathologist
looks at the tissue samples under a microscope. If cancer cells are present,
the shape, size and arrangement of the cells may help determine the type
of pancreatic cancer. However, obtaining a conclusive biopsy can be difficult.
Fine-needle aspiration (FNA) is the most common biopsy procedure for suspected
pancreatic cancer. There are two methods for performing FNA: the percutaneous
approach and the EUS-guided approach. During a percutaneous FNA, a local
anesthetic and a cleaning solution are applied on the skin. Then, a thin
needle is inserted through the abdominal wall. The doctor uses the image
from a CT scan or ultrasound to guide placement of the needle. The needle
is directed into the pancreas to remove cells from the tumor.
The EUS-guided FNA method involves passing the needle down the throat
through a special endoscope during an endoscopic ultrasound (EUS) imaging
procedure. This process involves imaging the tumor with ultrasound and
inserting a thin needle through the stomach or duodenal wall immediately
next to the pancreas. Unlike percutaneous FNA, there is no pain with the
EUS-guided approach. EUS-guided FNA performed by a specially-trained and
experienced doctor is the most accurate biopsy method for the pancreas
in most circumstances.
Other biopsy methods, such as a brush biopsy or forceps biopsy, can be
performed during an ERCP. In a brush biopsy, a small brush is introduced
through the endoscope to rub off cells from the bile duct or pancreatic
duct. The chance of getting a diagnosis of pancreatic cancer with ERCP
brushings is generally low compared to other methods.
In a forceps biopsy, forceps are passed through the endoscope and a small
piece of tissue is removed. Forceps are an instrument used by a surgeon
for grasping or extracting tissue.
Lastly, a biopsy sample can also be taken during surgery.
The information and services provided by the Pancreatic Cancer Action Network, Inc. are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, see a doctor immediately! The Pancreatic Cancer Action Network does not recommend nor endorse any specific physicians, products or treatments even though they may be mentioned on this site. In addition, please note that any personal information you provide to the Pancreatic Cancer Action Network's associates during telephone and/or email consultations may be stored in a secure database to assist the Pancreatic Cancer Action Network, Inc. in providing you with the best service possible. Portions of the constituent data stored in this database may be used to inform future programs and services of the Pancreatic Cancer Action Network, Inc., and may be provided in aggregate form to third parties to guide future pancreatic cancer research and treatment efforts. The Pancreatic Cancer Action Network, Inc. will not provide personal identifying information (such as your name or contact information) to third parties without your advanced written consent. 111230