Is hepatocellular carcinoma typically biopsied? Why or why not?

The choice indicating that biopsies are typically not performed for hepatocellular carcinoma is grounded in the concern that there is a risk of spreading the tumor along the needle track during the biopsy procedure. This type of cancer is often diagnosed through imaging studies and blood tests, such as measuring alpha-fetoprotein (AFP) levels, rather than relying on tissue sampling.

Because hepatocellular carcinoma often arises in the context of chronic liver disease, where the liver's condition can be compromised, a biopsy might not only pose risks such as bleeding and infection, but the potential for tumor seeding inadvertently raises concerns about the safety of the procedure. In many cases, the diagnosis can be established with adequate imaging techniques and lab work, which mitigate the need for a biopsy, thus avoiding the associated risks.

While there are situations where a biopsy might be necessary, especially if the diagnosis remains uncertain after non-invasive tests, a general guideline in practice favors non-invasive diagnostic methods to establish the diagnosis of hepatocellular carcinoma without the additional risks that a biopsy might entail.