When a lump or bump is found on a physical exam or a tumor/nodule/lesion is seen on imaging, it can be concerning. But how do we know for sure if it’s a malignant tumor vs a benign tumor? The answer is a biopsy.
A biopsy is a procedure in which a small piece of the suspicious tissue is removed and examined under a microscope by a pathologist. This allows the pathologist to see the cells and structure of the tissue and determine if it is benign or malignant or an aggressive tumor. A benign tumor will cause no harm, aggressive tumors like to grow in their place causing harm to the local surrounding area, and malignant tumors cause harm not only growing locally but also have the propensity to spread to different parts of the body or in other words.. metastasizing.
Once a malignant diagnosis is ascertained, then a definitive diagnosis can be given often with the use of immunohistochemistry stains and/or molecular testing. The pathologist looks at the slides and can most often tell if it’s a primary tumor or secondary tumor. For example, if a tumor is in the lung, did the cancer start there or in other words primary lung cancer? Or did it end up there like metastatic colon cancer or pancreas cancer spreading to the lungs. They can also tell us if it’s a carcinoma, lymphoma/leukemia, melanoma, sarcoma, neuroendocrine tumor analogous to looking at the skin of a brown bear, polar bear or a panda bear. Treatment decisions can vary widely based on this specific diagnosis in addition to the stage, patient condition, age, and other patient specific medical issues.
There are different types of biopsies that can be done, depending on the location and size of the tumor. A fine needle aspiration biopsy uses a thin needle to take a small sample of cells, while an excisional biopsy or the ultimate biopsy removes the entire lump. In some cases, a core needle biopsy or a surgical biopsy may be needed.
So, if you or a loved one have been told that a lump or bump needs to be biopsied, don’t fret yet! It’s just a way for the doctors to get a better look under the “skin” and make sure they give you the correct diagnosis. Trust the process and remember, a biopsy is the best way to know for sure what’s going on inside. Plus, do not assume all tumors are malignant. Most are often benign.
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. Currently practicing at the renowned Orlando Health Cancer Institute, he brings a wealth of expertise to the complex and challenging world of oncology.
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