What Percent of Neck Biopsies Are Cancer?

Medically Reviewed on 4/6/2022
What percent of neck biopsies are cancer
Nearly 75 percent of lateral neck biopsies done in patients older than 40 years of age are cancerous.

Most neck masses are noncancerous, but persistent, continuously growing neck mass requires a neck biopsy. Nearly 75 percent of lateral neck biopsies done in patients older than 40 years of age are cancerous. This is because only suspicious neck masses are biopsied.

The incidence of head and neck squamous cell carcinoma globally is 550,000 cases, accounting for five percent of new cases of cancer.

Squamous cell carcinomas account for most head and neck malignancies. This cancer starts in the flat squamous cells that make up the thin layer of tissue on the surface of the structures in the head and neck.

What is a neck biopsy?

A biopsy is performed by removing a sample of the tissue from the neck lump. A pathologist (a professional doctor) examines this piece of tissue under a microscope to establish a diagnosis.

  • A biopsy may be recommended by the doctor to determine whether the patient has cancer or what type of cancer it is.
  • Different types of biopsies can be performed, and the type of biopsy is determined by the patient’s medical history and the location of the tumor.

3 types of neck biopsies

  1. Incision biopsy
    • A doctor uses a surgical knife to remove a little bit of tissue from the afflicted region. This may be done in the clinic under anesthesia, so the patient does not feel any discomfort. Stitches may be required depending on the size and location of the biopsy.
    • Following the biopsy, there may be some bleeding. If the patient is on blood thinners (such as warfarin), it is recommended to discontinue such medications for a few days before the biopsy.
  2. Fine needle aspiration (FNA)
    • FNA is done when the patient lumps (enlarged lymph node) in the neck that may contain cancer cells. The doctor uses a needle to extract a tiny sample of cells from the lump during the process. A radiologist or pathologist will use an ultrasound to ensure that the needle is in the correct location. The patient may experience some pain during the procedure.
    • To get more tissue during the biopsy, a bigger needle may be utilized. This is called a core biopsy. It can offer more information than a needle biopsy but is more painful. The doctor will choose which type of biopsy is to be done depending on the condition of the patient.
  3. Lymph node excision biopsy
    • A lymph node excision biopsy involves the removal of an entire lymph node. When a needle biopsy does not reveal the cause of the swollen lymph node, this procedure is frequently used.
    • In certain cases, if there are no enlarged lymph nodes or identifiable indications of cancer in the nodes, the doctor may order a sentinel node biopsy to see if cancer has progressed to the lymph nodes. Sentinel node biopsy determines the first lymph node (the sentinel node) to which cancer cells are most likely to spread.
    • Biopsies of the throat or larynx (examination under anesthesia or laryngoscopy) require patients to be under general anesthesia (medicine to keep the patient unconscious) during the procedure. It allows the doctor to examine for unexpected things more attentively. This is completed in a single day, so the patient will not be required to stay in the hospital overnight. The biopsy tissue is delivered to a pathologist to be examined under a microscope. It may take several days or weeks to receive the findings.
    • It is common to feel a little pain and have some bruises in the location where the sample was extracted after the biopsy. Speak with the doctor or nurse about alternatives for pain or discomfort relief.


Skin Cancer Symptoms, Types, Images See Slideshow

What are the causes of a neck mass?

Non-cancerous causes of a neck mass include:

Adults with cancerous neck tumors are mostly caused by head and neck squamous cell carcinoma (HNSCC). Other malignancies that can produce a neck tumor include:

Tobacco use and alcohol consumption are the two leading causes of malignancies of the mouth, throat, larynx, and tongue. A human papillomavirus (HPV) infection is another major risk factor for malignancies of the neck, throat, and mouth. In most cases, HPV infection is transmitted sexually. "Oral HPV" refers to HPV discovered in the mouth and throat. Some kinds of high-risk oral HPV infections can lead to head and neck cancer.

Because of the rise in HPV infections, there has been an increase in HNSCC of the tonsil and base of the tongue. HPV-related malignancies frequently lack the conventional risk factors of tobacco and alcohol use, and they disproportionately afflict young individuals.

19 signs and symptoms of a cancerous neck mass

The following symptoms or indicators are common in people with head and neck cancer:

  1. Non-healing sore or swelling around chin and neck area
  2. Nausea
  3. Fatigue
  4. Lump in the neck with or without pain
  5. Fever of unknown origin
  6. Rashes
  7. Persistent sore throat
  8. Change in voice or hoarseness
  9. Blood in saliva and mucus discharge from the respiratory passage
  10. Pain and swelling around the jaw
  11. Difficulty breathing
  12. Pain with swallowing
  13. Pain in teeth and issues with dentures
  14. Red or white patch in the mouth
  15. Bad odor of mouth
  16. Numbness of regions in the neck
  17. Unexplained weight loss
  18. Ear pain or infection
  19. Double vision

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Medically Reviewed on 4/6/2022
Image Source: iStock Images

American Society of Clinical Oncology. Head and Neck Cancer. https://www.cancer.net/cancer-types/head-and-neck-cancer/introduction

Adeel M, Jackson R, Peachey T, Beasley N. Ultrasound core biopsies of neck lumps: an experience from a tertiary head and neck cancer unit. J Laryngol Otol. 2021 Sep;135(9):799-803. doi: 10.1017/S0022215121001833.

American Academy of Otolaryngology — Head and Neck Surgery. Neck Mass in Adults: Guideline for Evaluation Provides Framework for Timely Diagnosis. https://www.entnet.org/resource/aao-hnsf-updated-cpg-neck-mass-press-release-fact-sheet/