Skip to main content
SpringerLink
Log in

Oral Biopsy: Principles and Practice

  • Chapter
  • First Online:
Textbook of Oral Cancer

Part of the book series: Textbooks in Contemporary Dentistry ((TECD))

  • 1709 Accesses

Abstract

Biopsy plays a key role in the investigation of malignant disorders and is the cornerstone of diagnosis and management of oral cancer and oral potentially malignant disorders (OPMDs). Histological examination of the tissue from the biopsy is the initial step in confirmation or refutation of clinical diagnoses and assists in the development of a treatment protocol for patients with oral cancer or OPMDs. In addition to this important pretreatment role, biopsies done during and after treatment are critical to establish a successful treatment outcome or to identify failures and to detect recurrences. A thorough understanding of the biopsy principles, procedures, and medicolegal issues associated with the process is imperative for the practitioner and a foundation for good clinical practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Nezelof C, Guinebretière JM. 1879, Ernest Besnier inventor of the word “biopsy” [in French]. Rev Prat. 2006;56(18):2081–5.

    PubMed  Google Scholar 

  2. http://www.eaom.eu/pdf/content/oral_biopsy.pdf. Accessed on 07 July 2018.

  3. Ehrhart N. Principles of tumor biopsy. Clin Tech Small Anim Pract. 1998;13(1):10–6.

    Article  Google Scholar 

  4. McAndrew PG. Oral cancer biopsy in general practice. Br Dent J. 1998;185:428.

    Article  Google Scholar 

  5. Warnakulasuriya S, Johnson NW, van der Waal IJ. Nomenclature and classification of potentially malignant disorders of the oral mucosa. Oral Pathol Med. 2007;36:575–80.

    Article  Google Scholar 

  6. Williams PM, Poh CF, Hovan AJ, Ng S, Rosin MP. Evaluation of a suspicious oral mucosal lesion. JCDA. 2008;74(3). www.cda-adc.ca/jcda, April 2008.

  7. American Association of Oral and Maxillofacial Surgeons Position paper: Medication-Related Osteonecrosis of the Jaw: 2014 Update. https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/mronj_position_paper.pdf.

  8. Patton LL. The effectiveness of community-based visual screening and utility of adjunctive diagnostic aids in the early detection of oral cancer. Oral Oncol. 2003;39:708–23.

    Article  Google Scholar 

  9. Patton LL, Epstein JB, Kerr AR. Adjunctive techniques for oral cancer examination and lesion diagnosis: a systematic review of the literature. JADA. 2008;139(7):896–905.

    PubMed  Google Scholar 

  10. Epstein JB, Güneri P. The adjunctive role of toluidine blue in detection of oral premalignant and malignant lesions. Curr Opin Otolaryngol Head Neck Surg. 2009;17(2):79–87.

    Article  Google Scholar 

  11. Zhang L, Williams M, Poh CF, Laronde D, Epstein JB, Durham S, Nakamura H, Berean K, Hovan A, Le ND, Hislop G, Priddy R, Hay J, Lam WL, Rosin MP. Toluidine blue staining identifies high-risk primary oral premalignant lesions with poor outcome. Cancer Res. 2005;65(17):8017–21.

    Article  Google Scholar 

  12. Portugal LG, Wilson KM, Biddinger PW, Gluckman JL. The role of toluidine blue in assessing margin status after resection of squamous cell carcinomas of the upper aerodigestive tract. Arch Otolaryngol Head Neck Surg. 1996;122(5):517–9.

    Article  Google Scholar 

  13. Junaid M, Choudhary MM, Sobani ZA, Murtaza G, Qadeer S, Ali NS, Khan MJ, Suhail A. A comparative analysis of toluidine blue with frozen section in oral squamous cell carcinoma. World J Surg Oncol. 2012;10:57. https://doi.org/10.1186/1477-7819-10-57.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kazanowska K, Hałon A, Radwan-Oczko M. The role and application of exfoliative cytology in the diagnosis of oral mucosa pathology –contemporary knowledge with review of the literature. Adv Clin Exp Med. 2014;23(2):299–305.

    Article  Google Scholar 

  15. Remmerbach TW, Weidenbach H, Pomjanski N, Knops K, Mathes S, Hemprich A, Böcking A. Cytologic and DNA-cytometric early diagnosis of oral cancer. Anal Cell Pathol. 2001;22(4):211–21.

    Article  Google Scholar 

  16. Mehrotra R, Singh MK, Pandya S, Singh M. The use of an oral brush biopsy without computer-assisted analysis in the evaluation of oral lesions: a study of 94 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:246–53.

    Article  Google Scholar 

  17. Rahman F, Tippu SR, Khandelwal S, Girish KL, Manjunath BC, Bhargava A. A study to evaluate the efficacy of toluidine blue and cytology in detecting oral cancer and dysplastic lesions. Quintessence Int. 2012;43(1):51–9.

    PubMed  Google Scholar 

  18. Remmerbach TW, Pomjanski N, Bauer U, Neumann H. Liquid-based versus conventional cytology of oral brush biopsies: a split-sample pilot study. Clin Oral Investig. 2017;21(8):2493–8.

    Article  Google Scholar 

  19. Solomon D, Davey D, Kurman R, Moriarity A, O’Connor D, Prey M, et al. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA. 2002;287:2114–9.

    Article  Google Scholar 

  20. Kujan O, Desai M, Sargent A, Bailey A, Turner A, Sloan P. Potential applications of oral brush cytology with liquid-based technology: results from a cohort of normal oral mucosa. Oral Oncol. 2006;42(8):810–8.

    Article  Google Scholar 

  21. Husain A, Kujan O, Farah CS. The utility of oral brush cytology in the early detection of oral cancer and oral potentially malignant disorders: a systematic review. J Oral Pathol Med. 2018;47(2):104–16.

    Article  Google Scholar 

  22. Sciubba JJ. Improving detection of precancerous and cancerous oral lesions: computer-assisted analysis of the oral brush biopsy. JADA. 1999;130:1445–57.

    PubMed  Google Scholar 

  23. Poate TW, Buchanan JA, Hodgson TA, Speight PM, Barrett AW, Moles DR, Scully C, Porter SR. An audit of the efficacy of the oral brush biopsy technique in a specialist Oral Medicine Unit. Oral Oncol. 2004;40(8):829–34.

    Article  Google Scholar 

  24. Scheifele C, Schmidt-Westhausen AM, Dietrich T, Reichart PA. The sensitivity and specificity of the OralCDx technique: evaluation of 103 cases. Oral Oncol. 2004;40(8):824–8.

    Article  Google Scholar 

  25. Bhoopathi V, Mascarenhas AK. Effectiveness of oral surgeons compared with OralCDx brush biopsy in diagnosing oral dysplastic lesions. J Oral Maxillofac Surg. 2011;69(2):428–31.

    Article  Google Scholar 

  26. Seijas-Naya F, García-Carnicero T, Gándara-Vila P, Couso-Folgueiras E, Perez-Sayans M, Gandara-Vila R, Garcia-Garcia A, Gandara-Ray J-M. Applications of OralCDx methodology in the diagnosis of oral leukoplakia. Med Oral Patol Oral Cir Bucal. 2012;17(1):e5–9.

    Article  Google Scholar 

  27. Yuen HY, Lee YYP, Bhatia K, Ahuja AT. A short review of basic head and neck interventional procedures in a general radiology department. Cancer Imaging. 2013;13(4):502–5.

    Article  Google Scholar 

  28. Kahn MA, Lynch DP, Turner JE, Mincer HH. The dos and don’ts of an oral mucosal biopsy performed by the general dentist. J Tenn Dent Assoc. 1998;78:28–31.

    PubMed  Google Scholar 

  29. Miloro M, Ghali GE, Peter Waite PL. Peterson’s principles of oral and maxillofacial surgery. 3rd ed: McGraw-Hill Medical; 2012. p. 512–32.

    Google Scholar 

  30. Parker S. Laser – tissue interaction. Int J Laser Dentistry. 2011;1(1):1–8.

    Google Scholar 

  31. Bhatsange A, Meshram EP, Waghamare A, Shiggaon L, Mehetre V, Shende A. A clinical and histological comparison of mucosal incisions produced by scalpel, electrocautery, and diode laser: a pilot study. J Dent Lasers. 2016;10:37–42.

    Article  Google Scholar 

  32. Eversole LR. Laser artefacts and diagnostic biopsy. Oral Surg Oral Med Oral Pathol. 1997;83:639–40.

    Article  Google Scholar 

  33. Mistry RC, Qureshi SS, Kumaran C. Post-resection mucosal margin shrinkage in oral cancer: quantification and significance. J Surg Oncol. 2005;91(2):131–3.

    Article  Google Scholar 

  34. Thavarajah R, Mudimbaimannar VK, Elizabeth J, Rao UK, Ranganathan K. Chemical and physical basics of routine formaldehyde fixation. J Oral Maxillofac Pathol. 2012;16:400–5.

    Article  Google Scholar 

  35. Chen CH, Hsu MY, Jiang RS, Wu SH, Chen FJ, Liu SA. Shrinkage of head and neck cancer specimens after formalin fixation. J Chin Med Assoc. 2012;75(3):109–13.

    Article  Google Scholar 

  36. Allen CM. The oral pathology report: submission of specimens and interpretation of results. Dermatol Ther. 2002;15:179–84.

    Article  Google Scholar 

  37. Sadri D, Farhadi S, Mohammadi M, Seyedpour SM. Frequency of technical errors in the biopsy samples submitted to an oral and maxillofacial pathology laboratory. J Res Dentomaxillofac Sci. 2017;2(2):29–33.

    Article  Google Scholar 

  38. http://screening.iarc.fr/atlasoral.php. Accessed 2018-07-06.

  39. Seoane J, Varela-Centelles P, Ramirez JR, et al. Artefacts produced by suture traction during incisional biopsy of oral lesions. Clin Otolaryngol. 2002;27:549–53.

    Article  Google Scholar 

  40. Wang Y, Springer S, Mulvey CL, Silliman N, Schaefer J, Sausen M, et al. Detection of somatic mutations and HPV in the saliva and plasma of patients with head and neck squamous cell carcinomas. Sci Transl Med. 2015;7:293ra104.

    Article  Google Scholar 

  41. Ashworth T. A case of cancer in which cells similar to those in the tumors were seen in the blood after death. Aust Med J. 1869;14:146–7.

    Google Scholar 

  42. Braun S, Vogl FD, Naume B, Janni W, Osborne MP, Coombes RC, et al. A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med. 2005;353:793–802.

    Article  Google Scholar 

  43. Wang Z, Cui K, Xue Y, Tong F, Li S. Prognostic value of circulating tumor cells in patients with squamous cell carcinoma of the head and neck: a systematic review and meta-analysis. Med Oncol. 2015;32:164.

    Article  Google Scholar 

  44. Economopouloua P, Kotsantisa I, KyrodimosbLianidouc ES, Psyrri A. Liquid biopsy: an emerging prognostic and predictive tool in head and neck squamous cell carcinoma (HNSCC). Focus on circulating tumor cells (CTCs). Oral Oncol. 2017;74:83–9.

    Article  Google Scholar 

  45. Epstein RA. The negligence issue. In: Epstein RA, editors. Cases and materials on torts. 6th ed. Boston: Little Brown and Co; 1995. p. 168–71.

    Google Scholar 

  46. Allen TC. Medicolegal issues in pathology. Arch Pathol Lab Med. 2008;132(2):186–91.

    PubMed  Google Scholar 

  47. Epstein JB, Kish RV, Hallajian L, Sciubba J. Head and neck, oral, and oropharyngeal cancer: a review of medicolegal cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(2):177–86.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral Pathology, Ragas Dental College and Hospital, Chennai, India

    Ranganathan Kannan

Authors
  1. Ranganathan Kannan
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Faculty of Dentistry, Oral & Craniofacial Sciences,, King’s College London, London, UK

    Saman Warnakulasuriya

  2. Department of Orofacial Sciences, Schools of Dentistry and Medicine, University of California San Francisco, San Francisco, CA, USA

    John S. Greenspan

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kannan, R. (2020). Oral Biopsy: Principles and Practice. In: Warnakulasuriya, S., Greenspan, J. (eds) Textbook of Oral Cancer. Textbooks in Contemporary Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-030-32316-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-32316-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-32315-8

  • Online ISBN: 978-3-030-32316-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation