Biopsy and IHC: how they work together

During a biopsy, a clinician removes a sample from an abnormal area using a needle, an endoscope or surgery. The pathology laboratory processes the material and first examines its appearance under a microscope. IHC, short for immunohistochemistry, is an additional laboratory method performed on the sample rather than a separate procedure on your body.

For IHC, antibodies attach to selected proteins in the cells and produce a visible stain. The pattern and location of staining can help distinguish tumour types, investigate where a cancer may have started and evaluate markers that may influence treatment choices. A positive or negative stain is not interpreted alone: the pathologist considers the whole panel, the tissue appearance and the clinical information.

Before the biopsy, provide an up-to-date list of medicines, especially anticoagulants and antiplatelet drugs, and mention allergies or previous bleeding difficulties. Follow the procedure team's instructions about eating, drinking, transport and wound care. Never pause a prescribed blood thinner without advice from the clinician responsible for the procedure.

Ask when the initial pathology report is expected and whether extra stains could extend the reporting time. Results may arrive in stages as the pathologist selects further markers. Make a follow-up appointment to review the complete interpretation, including whether the material was adequate and whether molecular testing or another sample is recommended.

Call the clinical team if the wound becomes increasingly painful, hot or red, develops discharge, continues bleeding after pressure, or if you develop fever or chills. Obtain emergency help for breathing difficulty, collapse, heavy bleeding or rapidly increasing swelling, particularly after a biopsy near the airway. IHC itself is performed in the laboratory and does not cause physical side effects; aftercare concerns relate to the biopsy procedure.

Ask which diagnosis the IHC panel supports, whether any stains were uncertain and whether the sample quality limited interpretation. It can also help to ask if a marker affects treatment selection, whether the result needs confirmation by another method, and how this report fits with imaging and other clinical findings.