Comprehensive Cancer Biopsy
Our goal in biopsy is to reliably obtain the highest quality samples of our patients' cancer, using safe and precise minimally invasive techniques. We take a comprehensive approach to biopsy, with the goal of providing the most helpful information to our patients.
We provide our patients with suspected or known cancer a personalized approach to biopsy, the most advanced image guided sampling, and access to state of the art tumor molecular diagnostic technologies, such as liquid biopsy analysis and tissue biopsy genetic sequencing. This is at the forefront of precision medicine and personalized cancer care.
The Society of Interventional Radiology (SIR) published a consensus report on how image guided biopsy should evolve to meet the future needs of patients in this era of personalized cancer care. Dr. Tamrazi was 1 of 5 Interventional Radiologists invited to participate in generating the final published report. See Image-Guided Biopsy in the Era of Personalized Cancer Care: Proceedings from the Society of Interventional Radiology Research Consensus Panel, Journal of Vascular and Interventional Radiology, 2016.
Proper biopsy is crucial. In this era of personalized medicine and precision cancer care with targeted therapies, it is more vital than ever that your biopsy be performed properly so that useful information can be gathered to help your oncologist select trials and treatment options that are most likely to be effective for you. Many times, to be eligible for a trial or targeted drug therapy, specific cancer genetic biomarkers must be demonstrated in the patient. If a biopsy is done improperly, those cancer-specific features cannot be demonstrated (even if they are present in the patient), leading to ineligibility that is improper in cases where the biomarkers are, in fact, present in the patient, but are not picked up in the biopsy.
Poor biopsies are widespread and have real consequences for patients. A recent study found that as many as 1 in 5 samples obtained from patients with advanced cancer in a major precision cancer care trial were insufficient for complete analysis, in most cases because the biopsy had been poorly done. Patients with poor biopsies were dropped from the trial, even though they may have been eligible if they had proper biopsies. Shoddy biopsies deny cancer patients a shot at personalized treatment, STAT News, Boston Globe Media, 22 Jan. 2016.
We take a unique, patient-focused approach to biopsy, resulting in better biopsies, more reliably. We work closely with our patients’ treatment teams, including their surgeons and oncologists, to know exactly what information each patient needs to be eligible for a particular drug or trial and to make the next treatment decision, which we call the “clinical question.” We thoroughly evaluate each patient’s imaging to understand where the tumor is located and what the best access points are. Knowing the clinical question and the particulars of the patient’s anatomy, we are able to determine the best type of biopsy to perform – whether that is tissue biopsy, liquid biopsy, or both – and the best approach to take. We describe tissue and liquid biopsies below.
We use our expertise to perform biopsies properly and consistently. After determining the best type of biopsies to take and the approach, it’s all about execution. We use state of the art minimally invasive image guided techniques to obtain proper biopsies for our patients: we obtain an adequate amount of sample with the correct type of biopsy. As with all IR procedures, sampling procedures are often performed with sedation to make patients feel comfortable and relaxed, and general anesthesia is typically not needed. Patients usually get to go home the same day as their procedure.
We go a step further by sending our biopsies out for the best available analysis. We integrate our advanced biopsy techniques with the latest advances in molecular diagnostics by sending our samples out for analysis by the best available molecular analysis platforms. Analysis results in valuable data regarding genetic biomarkers and other tumor features, such as actionable mutations or resistant mutations, which can be used by our patients’ oncologists to offer to our patients the next treatment, with the best chance of working against their particular disease. This may include FDA-approved targeted drug therapies personalized for a patient’s particular cancer or, as an alternative option, targeted drug treatment trials based on the particular tumor signals demonstrated in a patient’s biopsy. This is at the forefront of precision medicine.
We look forward to being an integral part of your oncology team throughout your cancer treatment. In the era of personalized medicine and precision cancer care, biopsies are no longer performed only at the time of initial diagnosis. Biopsies are now performed at multiple time points throughout a patient’s cancer treatment: for example, to determine whether or how a tumor is responding to treatment, to predict prognosis, and to identify which targeted drug therapies may work best at different times of treatment. Part of our comprehensive approach to biopsy is to be available and play an active role in caring for our patients, throughout each patient’s entire cancer journey.
For an appointment, please call 650.366.0225.
We provide our patients with suspected or known cancer a personalized approach to biopsy, the most advanced image guided sampling, and access to state of the art tumor molecular diagnostic technologies, such as liquid biopsy analysis and tissue biopsy genetic sequencing. This is at the forefront of precision medicine and personalized cancer care.
The Society of Interventional Radiology (SIR) published a consensus report on how image guided biopsy should evolve to meet the future needs of patients in this era of personalized cancer care. Dr. Tamrazi was 1 of 5 Interventional Radiologists invited to participate in generating the final published report. See Image-Guided Biopsy in the Era of Personalized Cancer Care: Proceedings from the Society of Interventional Radiology Research Consensus Panel, Journal of Vascular and Interventional Radiology, 2016.
Proper biopsy is crucial. In this era of personalized medicine and precision cancer care with targeted therapies, it is more vital than ever that your biopsy be performed properly so that useful information can be gathered to help your oncologist select trials and treatment options that are most likely to be effective for you. Many times, to be eligible for a trial or targeted drug therapy, specific cancer genetic biomarkers must be demonstrated in the patient. If a biopsy is done improperly, those cancer-specific features cannot be demonstrated (even if they are present in the patient), leading to ineligibility that is improper in cases where the biomarkers are, in fact, present in the patient, but are not picked up in the biopsy.
Poor biopsies are widespread and have real consequences for patients. A recent study found that as many as 1 in 5 samples obtained from patients with advanced cancer in a major precision cancer care trial were insufficient for complete analysis, in most cases because the biopsy had been poorly done. Patients with poor biopsies were dropped from the trial, even though they may have been eligible if they had proper biopsies. Shoddy biopsies deny cancer patients a shot at personalized treatment, STAT News, Boston Globe Media, 22 Jan. 2016.
We take a unique, patient-focused approach to biopsy, resulting in better biopsies, more reliably. We work closely with our patients’ treatment teams, including their surgeons and oncologists, to know exactly what information each patient needs to be eligible for a particular drug or trial and to make the next treatment decision, which we call the “clinical question.” We thoroughly evaluate each patient’s imaging to understand where the tumor is located and what the best access points are. Knowing the clinical question and the particulars of the patient’s anatomy, we are able to determine the best type of biopsy to perform – whether that is tissue biopsy, liquid biopsy, or both – and the best approach to take. We describe tissue and liquid biopsies below.
We use our expertise to perform biopsies properly and consistently. After determining the best type of biopsies to take and the approach, it’s all about execution. We use state of the art minimally invasive image guided techniques to obtain proper biopsies for our patients: we obtain an adequate amount of sample with the correct type of biopsy. As with all IR procedures, sampling procedures are often performed with sedation to make patients feel comfortable and relaxed, and general anesthesia is typically not needed. Patients usually get to go home the same day as their procedure.
We go a step further by sending our biopsies out for the best available analysis. We integrate our advanced biopsy techniques with the latest advances in molecular diagnostics by sending our samples out for analysis by the best available molecular analysis platforms. Analysis results in valuable data regarding genetic biomarkers and other tumor features, such as actionable mutations or resistant mutations, which can be used by our patients’ oncologists to offer to our patients the next treatment, with the best chance of working against their particular disease. This may include FDA-approved targeted drug therapies personalized for a patient’s particular cancer or, as an alternative option, targeted drug treatment trials based on the particular tumor signals demonstrated in a patient’s biopsy. This is at the forefront of precision medicine.
We look forward to being an integral part of your oncology team throughout your cancer treatment. In the era of personalized medicine and precision cancer care, biopsies are no longer performed only at the time of initial diagnosis. Biopsies are now performed at multiple time points throughout a patient’s cancer treatment: for example, to determine whether or how a tumor is responding to treatment, to predict prognosis, and to identify which targeted drug therapies may work best at different times of treatment. Part of our comprehensive approach to biopsy is to be available and play an active role in caring for our patients, throughout each patient’s entire cancer journey.
For an appointment, please call 650.366.0225.
Types of Biopsy: Tissue and Liquid
There are two types of cancer biopsy: tissue and liquid. We describe each below.
Tissue Biopsy. Image guided tumor sampling is performed for patients with suspected or known cancer and entails obtaining tissue biopsy samples of a solid tumor using minimally invasive techniques under image guidance. Those tissue samples are then analyzed for type of tumor; for example, in a patient with a lung nodule, analysis of a tissue biopsy of the nodule can tell us whether the nodule is due to primary lung cancer or due to metastasized cancer from another organ, such as the kidney. Depending on the needs of a patient's referring clinician and future care, the tissue samples may also be sent out for detailed genetic and tumor biomarker analysis to help decide best treatment options.
Liquid Biopsy. At the forefront of precision cancer care is peripheral liquid biopsy sampling, in which blood samples obtained from a peripheral site, such as the arm, are analyzed for tumor markers. We have extensive expertise in this field and are familiar with the best molecular diagnostic companies and tests currently used to help oncologists personalize cancer therapy for a particular patient. We have access to and are familiar with liquid biopsy sample handling and processing, ensuring such tests are easily available to our patients if deemed medically necessary by our referring clinicians to help decide next steps in treatment.
To discuss with us whether a tissue or liquid biopsy might be appropriate for you, please call 650.366.0225.
Tissue Biopsy. Image guided tumor sampling is performed for patients with suspected or known cancer and entails obtaining tissue biopsy samples of a solid tumor using minimally invasive techniques under image guidance. Those tissue samples are then analyzed for type of tumor; for example, in a patient with a lung nodule, analysis of a tissue biopsy of the nodule can tell us whether the nodule is due to primary lung cancer or due to metastasized cancer from another organ, such as the kidney. Depending on the needs of a patient's referring clinician and future care, the tissue samples may also be sent out for detailed genetic and tumor biomarker analysis to help decide best treatment options.
Liquid Biopsy. At the forefront of precision cancer care is peripheral liquid biopsy sampling, in which blood samples obtained from a peripheral site, such as the arm, are analyzed for tumor markers. We have extensive expertise in this field and are familiar with the best molecular diagnostic companies and tests currently used to help oncologists personalize cancer therapy for a particular patient. We have access to and are familiar with liquid biopsy sample handling and processing, ensuring such tests are easily available to our patients if deemed medically necessary by our referring clinicians to help decide next steps in treatment.
To discuss with us whether a tissue or liquid biopsy might be appropriate for you, please call 650.366.0225.