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Biopsy and pathology

How to Choose a — Pathology Laboratory

Your biopsy report is the foundation of every treatment decision. The laboratory that processes it, and the pathologist who reads it, are worth choosing with care.

Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026

  • Accreditation is the starting point — NABL accreditation means an independent body has audited the laboratory. Without it, there is no external quality check.
  • The pathologist matters as much as the lab — An onco-pathologist reads cancer slides every day. Subspecialty experience matters most for unusual or complex cases.
  • The report shape affects what your oncologist can do — A detailed report with tumour type, grade, margins, and IHC gives your team far more to work from than a one-line diagnosis.
  • Ask about second opinions before you need one — Confirm the laboratory will release glass slides and the paraffin block. Once you need them, it is too late to find out they will not.
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Choose a laboratory that holds current NABL accreditation, has an onco-pathologist who reads cancer specimens, and can send your glass slides away for a second opinion. Accreditation confirms the laboratory meets standardised quality benchmarks verified by an independent body. Ask your oncologist whether they have a preferred laboratory they already trust.

How do you choose a pathology laboratory for a biopsy?

  1. Confirm NABL accreditation

    Ask the laboratory for their NABL accreditation number and whether it is current. NABL is the National Accreditation Board for Testing and Calibration Laboratories. An accredited laboratory has been audited by an independent body against defined quality and technical standards.

  2. Find out who will read your specimen

    Ask whether an onco-pathologist — a pathologist who subspecialises in cancer — will examine your biopsy. A general pathologist is qualified, but a subspecialist reads cancer slides every day. For an unusual or complex case, that experience can affect the report.

  3. Ask what the report will include

    A complete report should name the tumour type and grade, describe the extent of tissue involved, and include margin status for surgical specimens. If your oncologist has requested immunohistochemistry, confirm those results will appear in the same report.

  4. Confirm they store and can release your slides

    Ask whether the laboratory keeps the glass slides and paraffin block after the report is issued. If a second opinion is ever needed, those slides have to be physically sent to another pathologist. Find this out before you commit.

  5. Ask your oncologist

    Before you decide, ask your treating oncologist whether they have a laboratory they regularly work with. A working relationship between your oncologist and a specific pathologist can matter when a case needs further discussion or clarification.

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What should you check before choosing a pathology laboratory?

  • NABL accreditation is current — ask for the accreditation number
  • An onco-pathologist reads cancer specimens, not only a general pathologist
  • The report will include tumour type, grade, and margin status for surgical specimens
  • Immunohistochemistry (IHC) is available if your oncologist requires it
  • Glass slides and the paraffin block are stored after the report is issued
  • Slides can be sent to another laboratory if a second opinion is requested
  • Your oncologist has recommended or worked with this laboratory before

Does accreditation actually matter?

It does. NABL accreditation means an independent body has audited the laboratory's equipment, staining processes, staff qualifications, and reporting standards against a defined benchmark. A laboratory that is not accredited has not undergone that external check.

Accreditation does not guarantee a perfect result on every report. What it confirms is that the laboratory has systems in place to maintain consistency, handle complaints, and catch errors before a report is signed. That is meaningfully different from an unaudited laboratory.

Your oncologist's experience with a laboratory is also worth asking about. A pathologist who has worked with your oncologist for years and understands how they use reports is an asset that a certificate alone does not capture — and it is a reasonable question to put directly to your treating team.

Explore 112 more Markers, Molecular Testing and Test Accuracy topics

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Common questions

Frequently asked questions

What is NABL accreditation and why does it matter for a biopsy?

NABL accreditation means the laboratory has been independently audited and found to meet defined quality and technical standards for the tests it performs. For a biopsy, this confirms that staining processes, equipment, and reporting have all been externally verified. It is not a guarantee against any individual error, but it is the most reliable signal available to a patient that a laboratory maintains standardised quality. An unaccredited laboratory has not undergone that external check.

Is a more expensive laboratory necessarily better?

Not automatically. Price varies between laboratories for reasons that do not always reflect quality — location, branding, or services bundled into the cost. What matters more is accreditation, the subspecialty of the pathologist reading your specimen, and the detail of the report. Use the checklist on this page rather than price alone. If cost is a concern, ask your oncologist which criteria matter most for your specific cancer type.

Can I send my slides to a second laboratory if I am not confident in the first report?

Yes, and it is a reasonable thing to do. Ask the original laboratory to release your glass slides and paraffin block so they can be sent to another pathologist. That pathologist gives their own independent assessment without seeing the first report. If the two reports differ, your oncologist will review both and discuss with you how to proceed. A laboratory that discourages you from seeking a second opinion is a concern in itself.

What should a biopsy report include?

A complete report should name the tumour type and grade, describe the appearance and extent of the tissue, and include margin status if it is a surgical specimen. If immunohistochemistry was performed, those results belong in the same document. A report that states only the diagnosis without supporting detail is harder for your oncologist to act on. It is reasonable to ask the laboratory what their standard report format includes before you proceed.

What happens if two pathologists give different diagnoses?

Disagreement between pathologists happens, and it does not mean the system has failed. Some cancer diagnoses sit on a spectrum and are genuinely difficult to classify. When reports differ, your oncologist may refer the case to a third specialist, to a tumour board, or to a centre with known subspecialty expertise in your cancer type. Bring both reports to your next appointment and ask your oncologist to explain where the disagreement lies and what the next step is.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

What Is a Biopsy? Everything You Need to Know →

Types of Biopsy Compared

Which Biopsy Will You Have? Techniques Compared →

Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

After a Biopsy: Recovery, Aftercare and Warning Signs →

Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

How to Read a Biopsy Report: Terms Explained →

IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

Cytology & Prostate Scoring Systems Explained →

How Accurate Is a Biopsy?

How Accurate Is a Biopsy? Errors and Second Opinions →

If Your Result Is Benign

Your Biopsy Is Benign: What It Means and What Comes Next →

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