Name of the Procedure:

Brush Biopsy - Tranepithelial Sample Collection (D7288) Commonly referred to as Brush Biopsy or Cytology Brush Biopsy.

Summary

A brush biopsy is a minimally invasive procedure used to collect cells from the surface layer of tissues. It employs a small brush to gently scrape cells for examination, often used in detecting abnormalities like cancer or pre-cancerous lesions in the oral cavity.

Purpose

Brush biopsies are primarily used to:

• Diagnose lesions that appear suspicious or abnormal.
• Detect conditions such as oral cancer, precancerous changes, or other pathology. The goal is to identify abnormal cells early for timely intervention and treatment.

Indications

Indications for a brush biopsy include:

• Persistent white or red patches in the mouth.
• Ulcers or sores that do not heal.
• Unexplained masses or growths. Patients with a history of tobacco use, heavy alcohol use, or other risk factors for oral cancers may be more frequently recommended for this procedure.

Preparation

Preparation for a brush biopsy generally involves:

• No specific fasting or dietary restrictions.
• Patients should inform the healthcare provider of any medications they are taking.
• Oral hygiene should be maintained, but no special pre-procedure assessments are typically required.

Procedure Description

1. The healthcare provider will locate the area of concern in the mouth.
2. A small, sterile brush will be gently inserted and rotated over the lesion to collect cells from various layers of the epithelium.
3. The brush is then removed, and the collected cells are transferred to a glass slide or container for cytological analysis. The procedure may cause minor discomfort but usually does not require anesthesia.

Duration

The procedure typically takes around 5 to 10 minutes.

Setting

Brush biopsies are often performed in:

• Dental offices
• Outpatient clinics
• Specialized medical centers

Personnel

The procedure is conducted by:

• Dentists
• Oral surgeons
• Trained healthcare professionals in cytology or pathology

Risks and Complications

Although usually safe, potential risks include:

• Minor bleeding at the biopsy site
• Slight discomfort during and after the procedure Rare complications may include:
• Infection at the site, manageable with proper care

Benefits

Expected benefits include:

• Early detection of oral cancers and precancerous changes.
• Quick and minimally invasive method to obtain tissue samples. Results are typically available within a few days, leading to prompt follow-up if necessary.

Recovery

Post-procedure care involves:

• Maintaining oral hygiene.
• Rinsing the mouth with a mild saline solution to prevent infection.
• Avoiding irritation of the biopsy site by refraining from eating spicy foods or smoking for a short period. Recovery is usually immediate, with no major restrictions.

Alternatives

Alternative diagnostic methods include:

• Surgical biopsy for more extensive tissue sampling.
• Imaging studies to visualize deeper structures but lack cellular detail. The pros of brush biopsy include its simplicity and less invasive nature, while surgical biopsies provide more comprehensive tissue samples but are more invasive.

Patient Experience

During the procedure, the patient may experience:

• Mild scraping sensation or discomfort but typically no significant pain. Post-procedure sensations might include:
• Minor soreness or tenderness at the biopsy site. Pain is generally minimal and can be managed with over-the-counter analgesics.