NCCN Guidelines for Patients
Adolescents and Young Adults with Cancer, Version 1.2017
Biopsies often include removal of tissue from nearby
lymph nodes. The lymph nodes are groups of small
round structures in the lymphatic system that help
fight disease. By removing lymph nodes, your doctor
can see if cancer has gone beyond the primary tumor.
Once the biopsy is complete, a pathologist will look at
the tissue sample—or samples—under a microscope
Whether the tumor is benign or malignant.
What kind of cancer it is.
If—or how far—the cancer has spread.
The pathologist may also perform other tests to see if
the cancer cells have specific genes (instructions for
cells) or proteins. This can help in understanding how
the cancer will act in the body and what treatment
should be given.
Biopsies are usually done by a surgeon, a doctor
specially trained in performing surgical procedures.
Imaging scans can be used during a biopsy to guide
the doctor when removing the tissue.
Biopsy techniques include:
Endoscopic biopsy –
a lighted scope is
inserted into an opening in the body to remove
tissue or cells through a tube.
Needle biopsy –
uses a needle to remove
fluid or tissue in the body.
Incisional biopsy –
surgical removal of a
sample of tumor tissue for testing.
Excisional biopsy –
surgical removal of the
entire tumor for testing.
Biopsies are the final step in a cancer diagnosis. Ask
your doctor or nurse to explain what biopsy you will
have and what you can do to get ready.
The pathology report
The pathology report is written by a doctor for
a doctor, which can make it hard for patients to
understand. The report will cover everything from your
name, age, and other details on who you are (check
this carefully). It will have details on how the biopsy
sample looks, how the cancer seems to be growing,
and what it’s likely to do.
Once all of your tests are done, the doctor will tell you
the stage of your disease. Staging tells the extent
of cancer in the body. Your doctor will stage your
disease to decide on a prognosis (the likely course
the cancer will take) and to choose the best treatment
The stage of the cancer may be expressed in several
Carcinoma in situ is limited to the layer of cells
where it began.
Localized cancer is limited to the organ where
Regional cancer has spread to nearby lymph
nodes or organs.
Distant cancer has spread to distant parts of
Unknown means there's not enough
information to determine the cancer’s stage.
Tumors may also be described as stage 0 through IV:
Stage 0 is a very early form of cancer that has
not yet invaded other areas.
Stage I–III indicates disease that is increasing
as the stages go up. This can include larger
tumor size and greater spread of cancer to
nearby organs or lymph nodes.
Stage IV indicates that the cancer has spread
to distant parts of the body.
Dealing with the diagnosis
How is cancer diagnosed?