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Making the Diagnosis of Cancer
People may present with:
new symptoms
unusual findings on routine physical examination
an abnormal screening test
unexpected finding on diagnostic imaging
These may suggest cancer, but tissue is required to confirm malignancy and make the diagnosis.
Tissue can be from either the primary tumour itself or a metastatic (distant area of spread) site. Efforts to obtain tissue will begin with the most simple, or least invasive, procedures and proceed to the more invasive procedures with the higher risk of complications for the patient.
The sample can be: cytology, core biopsy, incisional biopsy or a complete excision.
For example, in the evaluation of a lung lesion cells for cytology can be obtained through a sputum sample or bronchial washings at the time of bronchoscopy; tissue for histology can be obtained through a bronchial biopsy or an external FNA (fine needle aspiration).