Introduction to Clinical Oncology
Making the Diagnosis of Cancer

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).