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Most types of cancer are diagnosed with the help of a biopsya sample of potentially diseased tissue.
It can be obtained via needle aspiration, excision, or surgery.
This article dives into the specifics of this process and what the pathologist looks at in the biopsy.
Getty/Sigrid Gombert
Biopsy and Gross Examination
Abiopsyis a sample of potentially diseased or cancerous tissue.
Your surgeon might take a biopsy before or during tumor removal surgery.
Nearbylymph nodesmay also be removed to see if cancer has spread or metastasized locally.
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The most interesting thing about a biopsy is what happens after its takenthe analysis.
The first step in analyzing the tumor sample is gross examination.
In medicine, gross means the feature or characteristic can be seen without a microscope.
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They also prepare samples for the next steplooking at them under the microscope.
Histology and Cytology
You might hear that your biopsy sample is in the histology and cytology lab.
Sometimes samples are processed as frozen sections instead of being put in wax.
This process can be done while the patient is still in surgery to give faster results.
This can tell the surgeon if the tumor is cancerous and if theyve removed the entire tumor.
This process is faster but gives less detailed results.
At this point, the sample is ready for analysis under a microscope.
Cancer key in
Identifying thecancer typeis one of the primary aims of histopathology.
A cancers key in is the kind of tissue that it originated from.
Antibodies (like those used in IHC) are used to tag specific types of cells in the sample.
The sample containing these tagged cells is passed in front of an energy beam, making the antibodies glow.
Sometimes the antibodies will be used to detect cells with proteins called tumor markers, indicating theyre cancerous.
Hematoxylin turns the cells genetic material a deep purple color, and eosin turns proteins pink.
Tumor Grade vs. Cancer Stage
Tumor grading is purely an analysis of the tissue and cells sampled.
That being said, a higher stage cancer is usually also a higher grade cancer.
These cytogenetic studies dont look at cancer cells per se; they utilize tissue culture and other diagnostic techniques.
ThePhiladelphia chromosomeis one such change.
It happens when chromosomes 22 and 9 swap sections.
This change is found in chronic myelogenous leukemia and sometimes in acute lymphocytic leukemia.
It may take up to 10 days for the tests to be done and analyzed.
This can help you make more informed choices about your health and actively participate in your treatment decisions.
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National Cancer Institute, Surveillance, Epidemiology & End Results Program.Cancer stat facts: common cancer sites.
American Cancer Society.What happens to biopsy and cytology specimens?
American Cancer Society.What do doctors look for in biopsy and cytology specimens?
National Cancer Institute, SEER Training Modules.Tumor markers.
Chan JK.The wonderful colors of the hematoxylin-eosin stain in diagnostic surgical pathology.Int J Surg Pathol.
2014;22(1):12-32. doi:10.1177/1066896913517939
National Cancer Institute.Tumor grade fact sheet.
National Cancer Institute.Definition of Philadelphia chromosome.
National Cancer Institute.Definition of HER2.
National Cancer Institute.Pathology reports.
