An apparatus for needle biopsy with real time tissue differentiation using one dimensional interferometric ranging imaging, comprising a biopsy device having a barrel and a needle, an optical fiber inserted in the needle, and a fiber optic imaging system connected to the optical fiber. The imaging system obtains images and compares the optical properties and patterns to a database of normalized tissue sample images to determine different tissue types. The physician performing the biopsy obtains feedback via a feedback unit associated with the biopsy device and which is connected to the imaging system. The feedback unit can provide visual, audible or vibratory feedback as to tissue type encountered when the needle is inserted toward the target tissue. The feedback unit can be programmed for different biopsy procedures so that the user can actuate a button to select a display or other feedback mechanism for the desired procedure and anticipated tissue to be encountered.