A cancer diagnosis can only be confirmed through tissue or laboratory testing, never through imaging alone. At KD Cancer Centre, integrated biopsy and pathology services ensure precise, timely, and comprehensive diagnostic evaluation, forming the foundation of evidence-based treatment planning.

Why the biopsy report is the foundation of your treatment

The pathology report from your biopsy is the most important document in your cancer care. It determines

• Whether the lesion is cancer (malignant) or not (benign)
• The exact type of cancer,different histological types have completely different treatments
• The grade of the cancer, how aggressive the cells appear under the microscope
• Molecular and receptor status, which targeted therapies or immunotherapy may work
• The stage pathologically, how far the cancer has spread in the tissue

At KD Cancer Centre, every biopsy is reported by specialist oncological pathologists. We do not rely on generic histopathology, we apply the latest WHO Classification of Tumours (2022) and international diagnostic standards.

Biopsy services

Image-guided biopsies (Radiologist-Performed)

• CT-guided core needle biopsy: For deep lesions in the lung, liver, pancreas, retroperitoneum, or soft tissue; real-time CT targeting for precision
• Ultrasound-guided core needle biopsy: For superficial and abdominal masses, lymph nodes, breast lesions
• Endoscopic ultrasound (EUS)-guided FNA and core biopsy: For pancreatic masses, mediastinal nodes, submucosal GI lesions
• EBUS-TBNA: For mediastinal and hilar lymph node sampling without surgery
• Stereotactic biopsy: For non-palpable breast lesions detected only on mammography
• Vacuum-assisted biopsy (VAB): For microcalcifications and small breast lesions

Surgical biopsies

• Incisional biopsy: Removing a portion of a tumour for diagnosis (oral, skin, soft tissue tumours)
• Excisional biopsy: Complete removal of a smaller lesion for diagnosis and treatment
• Sentinel lymph node biopsy: Isotope and dye guided; breast and oral cancer
• Trephine bone marrow biopsy: For leukaemia, lymphoma, and multiple myeloma diagnosis

Endoscopic biopsies

• OGD (upper GI endoscopy) biopsy: Oesophagus, stomach, duodenum
• Colonoscopy biopsy: Colon and rectum
• Bronchoscopy biopsy: Endobronchial and transbronchial
• Hysteroscopy biopsy: Endometrial

Colposcopy biopsy: Cervical

Pathology and laboratory services

1. Histopathology: The cornerstone of cancer diagnosis

Tissue sections are prepared, stained with haematoxylin and eosin (H&E), and examined under the microscope by our pathologists. We report according to the CAP (College of American Pathologists) Cancer protocol, which provides standardised, internationally comparable pathology reports.

• Tumour type, grade, and extent
• Resection margins (clear, close, or involved)
• Lymphovascular and perineural invasion
• Pathological stage (pTNM — AJCC 8th Edition)
• Intraoperative frozen section: Provides rapid preliminary results during surgery to guide surgical decision-making.

2. Immunohistochemistry (IHC): Molecular identity of cancer

IHC uses antibodies applied to tissue sections to detect specific proteins and molecules. It is essential for

• Confirming cancer type (e.g. distinguishing adenocarcinoma from squamous cell carcinoma; identifying tumour origin in metastases)
• ER/PR/HER2 testing in breast cancer: Determines hormone therapy and Trastuzumab eligibility.
• ALK/ROS1/PD-L1 in lung cancer: Guides targeted and immunotherapy decisions
• CD20 in lymphoma: Guides rituximab therapy
• EGFR expression in head and neck cancer
• MMR proteins (MLH1/MSH2/MSH6/PMS2): Lynch syndrome and immunotherapy eligibility screening
• p53, Ki-67, Synaptophysin, Chromogranin, S100, and over 50 other markers

3. Molecular diagnostics and NGS

See our dedicated molecular and genetic services page for comprehensive details. Our molecular testing capabilities include

• PCR (Polymerase chain reaction): For specific known mutations (EGFR, KRAS, BRAF, JAK2, BCR-ABL)
• FISH (Fluorescence In Situ Hybridisation): For gene amplification and rearrangements (HER2, ALK, MYC, BCR-ABL)
• Next-generation sequencing (NGS): Comprehensive cancer gene panels covering 300+ cancer-relevant genes
• Liquid biopsy (ctDNA / cell-free DNA): Blood-based molecular profiling without tissue biopsy
• MSI (Microsatellite Instability) testing: For immunotherapy eligibility (pembrolizumab)
• TMB (Tumour mutational burden): Prediction of immunotherapy response

4. Cytology

• FNAC analysis: Rapid preliminary diagnosis from needle aspirates
• Fluid cytology: Pleural effusion, peritoneal (ascitic) fluid, pericardial fluid, CSF, urine
• Sputum cytology: Lung cancer screening
• Cervical cytology (Pap smear): Cervical cancer screening

5. Haematology and biochemistry laboratory

• Complete blood count (CBC) with differential: Essential for leukaemia diagnosis and treatment monitoring
• Bone marrow aspirate cytology and flow cytometry: For haematological malignancy diagnosis and immunophenotyping.
• Coagulation profile: Critical pre-surgery and during anticoagulation
• Tumour markers: CEA, CA 19-9, AFP, CA-125, PSA, CA 15-3, Thyroglobulin, Beta-hCG, LDH, Chromogranin A
• Renal and hepatic function, electrolytes: Monitoring treatment safety
• Therapeutic drug monitoring: For selected targeted therapies

Turnaround times

• FNAC / Cytology same day to 24 hours: Rapid preliminary results
• Frozen Section (intraoperative): 20–30 minutes during surgery
• Routine histopathology: 48–72 hours
• IHC 72–96 hours (added to histopathology as indicated)
• PCR / FISH 3–5 working days
• NGS (Next-generation sequencing) 7–14 working days
• Liquid biopsy 7–14 working days