Tests and scans
You may have a lung biopsy if your doctor has seen an abnormal looking area in your lung or airways using an or .
There are different ways your doctor can take a biopsy. These are:
a needle biopsy through the skin, also called a percutaneous lung biopsy
keyhole surgery, also called a video assisted thoracoscopic surgery (VATS)
open surgery called a small thoracotomy
You might hear the term surgical biopsy. Keyhole surgery and open surgery are both types of surgical biopsy.
You usually have written information explaining how to prepare for your lung biopsy. It’s important that you read and follow the instructions. There is usually a number to call if you have any questions. You might have blood tests beforehand to check your blood levels and how well your blood clots. Tell your doctor if you're taking medicines that changes how your blood clots. This includes:
warfarin or heparin
aspirin
clopidogrel
apixaban or rivaroxaban
ticagrelor
Your doctor will tell you if you need to stop taking these or any other medicines for a while before your biopsy. If you are having keyhole or open surgery, you will probably attend a pre assessment clinic before the test. During this visit, you will:
have an assessment to check if you are fit enough to have a surgical biopsy
have a blood test and any other tests you might need will be arranged
see an who will assess you. They will tell you what to expect from the anaesthetic and how your pain will be managed afterwards
You can't eat or drink for some time before the biopsy. Check your letter to find out when you need to stop eating and drinking. Contact the department in advance if this is a problem for you, for example, if you have diabetes.
This test is also called a percutaneous lung biopsy. A specialist doctor called a takes a sample of lung tissue by passing a needle into the lung. First, you have a CT scan or ultrasound scan. This helps the radiologist decide the best place to insert the needle for the biopsy. They then clean the area with antiseptic solution. They inject some into the area over your lung. This injection will sting at first. Then the area will become numb so you won't feel anything. The radiologist will ask you to hold your breath while they put a fine needle through your skin and into your lung to take the biopsy. You may feel some pressure from the biopsy needle as it takes the sample. You shouldn’t feel any pain. Tell the radiologist if you have pain. The radiologist takes out some tissue through the needle and into a syringe. They may have to repeat this part of the test 2 to 3 times to take a good sample.
After the biopsy you go back to the ward so you can rest. You can eat and drink as usual. You might need to stay in hospital overnight.
Your nurse monitors you closely for a few hours. They check your heart rate and oxygen levels using a clip on your finger. This doesn’t hurt. They check your blood pressure regularly, using a cuff on your arm. The biopsy area might feel tender or sore as the local anaesthetic begins to wear off. Your nurse makes sure any pain you have is under control. Ask for painkillers if you need them.
You usually have a chest x-ray an hour or more after the biopsy.
You have a waterproof dressing over your biopsy site. Your nurse will tell you how to look after the dressing over the next few days.
This test is called video assisted thoracoscopic surgery (VATS). You have this test in an operating theatre, under . So, you will be asleep and won’t feel anything.
Once you are asleep, you are turned on your side with your arm above your head. Your surgeon makes one or more small cuts in your chest. Each cut measures between 1cm to 5cm.
The number of cuts and the position depend on:
the type of surgical biopsy you have
which part of the lung the surgeon needs to take the biopsy from
Your surgeon will use a small flexible camera called a thorascope to look at parts of your lung. It shows pictures of the inside of your body on a television screen. They take out a small piece of the abnormal area to examine under a microscope.
After the biopsy they may put in one or more tubes close to the wounds to drain any extra fluid or air. These are called chest drains. Your nurse will remove them before you go home.
When you wake up you will be able to eat and drink again as soon as your doctor thinks it’s safe. You might have less appetite than normal. But you will have plenty of fluids through a drip. Your nurse can give you anti sickness medicines if you feel sick.
You usually stay in hospital for at least 3 days, but you might need to stay a bit longer to recover. Your nurse will give you instructions on how to take care of your wounds when you get home.
An open lung biopsy is also called a small thoracotomy. It is not used very often to diagnose lung cancer.
You have this test in an operating theatre, under general anaesthetic. So, you will be asleep and won’t feel anything.
Your surgeon makes a cut (incision), usually in the side of your chest. The size of the cut depends on where the abnormal cells are. This might vary between a few centimetres up to 30 cm long. The surgeon can look at any abnormal areas in your lung. They take tissue samples to examine under a microscope.
The surgeon uses stitches underneath the skin to close your wound. They may put in a tube close to the wound (a chest drain) to drain any extra fluid or air. Your nurse will remove this before you go home.
When you wake up you will be able to eat and drink again as soon as your doctor thinks it’s safe. You might have less appetite than normal. But you will have plenty of fluids through a drip. Your nurse can give you anti sickness medicines if you feel sick.
You usually stay in hospital for at least 3 days but you might need to stay a bit longer. Your nurse will give you instructions on how to take care of your wounds when you get home.
The possible risks include:
You might see a small amount of blood in your spit or cough up a little blood for a few days. Contact your healthcare team if this doesn’t go away or if there’s a lot of blood.
Contact your healthcare team or GP straight away if your phlegm (sputum) changes colour, you feel more breathless, you have chest pain or you feel as though you have a temperature.
Contact your healthcare team or GP if the dressing over your wound or biopsy site has lots of ooze on it.
You might need oxygen through a mask for a while after the biopsy. If you normally have oxygen at home you might need to have more than usual for a time.
Air or gas can collect in the space around the lung and make it collapse, but this is rare. Contact a doctor if you become short of breath or have chest pain. You have a tube put into the lung to remove the air.
Let your doctor know if you are due to fly soon after your biopsy. They can give you advice about how long you should wait before taking a flight.
It is quite common to have some pain after a surgical biopsy. You may have some tenderness or soreness following a needle biopsy through the skin. You usually have painkillers to take home. Let your doctor or nurse know if the painkillers are not working or your pain is getting worse.
Keyhole surgery or open surgery can increase the risk of getting a blood clot. Blood clots can be life threatening. You will have a daily injection to thin your blood to reduce this risk. You will also wear compression stockings to improve circulation in your legs. It is important to try and move as much as possible and to drink plenty of fluids.
Symptoms of a blood clot include:
pain, redness and swelling around the area where the clot is and may feel warm to touch
breathlessness
pain in your chest or upper back – dial 999 if you have chest pain
coughing up blood
You should get your results within 1 or 2 weeks, but it may take longer. Contact the doctor who arranged the test if you haven’t heard anything after this time.
Waiting for test results or for further tests can be very worrying. You might have contact details for a specialist nurse and you can contact them for information if you need to. It may help to talk to a close friend or relative about how you feel.
You can read more information about other tests to help doctors diagnose lung cancer.
Last reviewed: 24 Sept 2025
Next review due: 25 Sept 2028
You usually start by seeing your GP, and they might refer you to a specialist and organise tests. Or you might be referred to a specialist and further tests if screening for lung cancer or a lung health check showed that you might have lung cancer.
The stage of a cancer tells you how big it is and whether it has spread. The type tells which type of cell the cancer started from.
Your treatment depends on several factors. These include what type of lung cancer you have, how big it is and whether it has spread (the stage). It also depends on your general health.
Lung cancer starts in the windpipe (trachea), the main airway (bronchus) or the lung tissue. Cancer that starts in the lung is called primary lung cancer.
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