[Number of biopsies for EGC]

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How many biopsies do you take for suspected early gastric cancer (EGC)? If the EGC lesion is large and/or deep, I would recommend 4-6 biopsies.

Careful targeting is important for small EGC. In candidate cases for ESD (endoscopic submucosal dissection), I would recommend no more than 3 biopsies. Too many biopsies can make significant submucosal fibrosis, which makes the ESD procedure difficult.

When a patient with EGC is referred with good endoscopic pictures, I would not repeat endoscopy before ESD. Abdominal CT scan and the review of outside slides usually give enough information.