What happens to your biopsy?

It’s not the happiest news. Experts published in the most recent edition of the Journal of the American Medical Association suggest cancer is poised to become the leading cause of death worldwide. That’s despite major strides forward in cancer treatment and prevention.

That said, there is a lot you can do as an individual to reduce your risk. That includes things like healthy eating, staying active and being screened, when indicated. Cancer screening is something most of us will experience, and it simply means you’re being checked. If something suspicious is found, your doctor will likely order a biopsy, a sample of tissue taken for closer examination. And while you wait at home, worrying and wondering, what happens behind the scenes is something you simply have to see.

At Sunnybrook Health Sciences Centre, thousands of such tissue samples are sent to our state-of-the-art pathology lab every year. When I walked in for the first time, I was amazed by the process. It’s something patients usually never get to see. But if you click on my video link, I’ll walk you through every step and introduce you to our Chief of the Department of Anatomic Pathology, Dr. Mahmoud Khalifa.

Step one is receiving the sample, processing it into the system with a unique patient code number. A technician then sits at a table, cutting it into smaller pieces that will fit into a special color-coded cassette. The one-inch cassette is porous to allow different chemical solutions to pass through, the purpose being to dry out the tissue during overnight processing.

Once that’s complete, the sample moves on to a so-called embedding station, where it’s removed from the cassette and covered in liquid wax. The wax is then allowed to harden on a small black cold plate. You might wonder, why wax? The reason is that the wax suspends the tissue sample, allowing for the next step in this intricate process: cutting. Picture the meat slicer you find at the grocery store. Well, that’s what happens to the tissue suspended in wax: it’s sliced like salami so different depths of the sample can be examined. Then, these thin sheets of wax are placed to float in a small water bath, where the technologist can literally scoop up what they need onto a glass slide. These glass slides are labeled with the patient’s specific code to eliminate any mix-ups.

Once the section is on the slide, it needs to be stained so the pathologist can do their job. Pathologists are physicians who have specialized training and examine tissue, blood or other body fluids to help diagnose diseases, blood disorders and infections. The staining process takes about one hour, and the pink color allows for the cells to be viewed under the microscope to check for cancer. Sunnybrook has one of the most up-to-date staining systems in the country. By laying the glass slides flat, it virtually eliminates the risk that cells from one slide will contaminate another. In short, cutting the chance of receiving a false-positive result.

After staining, another technologist matches the slides with a pathology report before they are sent on. Sunnybrook is also a leader here, having teams of pathologists who specialize in each type of cancer. And that’s an added benefit to patients, especially in more complex cases.

Our hospital has one of the most robust quality assurance programs in Canada. And the bottom line for patients is simple: when they get a result, they can rest assured that every step has been taken to make sure it’s accurate.

I hope you’ll check out my video. It’s a story you won’t see anywhere else.