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Your IHC report explained

What Is — Immunohistochemistry (IHC)?

IHC — immunohistochemistry — is a laboratory test that stains a slice of your tumour tissue to show which proteins are inside the cells. That protein picture tells your oncologist which cancer type you have and what happens next.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • A protein map of your tumour — IHC identifies which proteins are present in the cancer cells, giving your oncologist a molecular fingerprint of the tumour.
  • Done on your existing biopsy — No extra procedure needed — the test is run on tissue already collected.
  • Results take days, not hours — Processing and reading the stained slides typically takes three to five working days.
  • Positive, negative, or scored — Results are recorded as present or absent, sometimes with a strength score from 0 to 3+.
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IHC applies labelled antibodies to a thin slice of your tumour tissue. Where an antibody finds its target protein, a colour reaction marks the cell. A pathologist reads the stained slide and records which proteins are present and how strongly. That protein profile confirms which cancer type you have.

What does IHC actually do?

The laboratory takes a thin slice of your biopsy tissue and applies a series of antibodies, each designed to bind to one specific protein. Where it binds, a dye produces a visible colour under the microscope.

A pathologist reads the result and records which proteins were found and at what strength. This pattern — the IHC profile — confirms the diagnosis and often reveals details that the biopsy tissue alone cannot show.

Why is IHC part of the cancer diagnosis?

  • Confirms the cancer typeSome cancers look identical under standard staining. IHC separates them by their protein fingerprint.
  • Identifies where the cancer startedWhen cancer is found in a distant site, IHC can point to which organ it came from.
  • Checks for clinically relevant proteinsCertain proteins matter for treatment planning. Their presence or absence is information your oncologist needs before deciding the next step.
  • Measures how actively cells are dividingKi-67 is one marker that tells your team about the growth behaviour of the cancer cells.

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How long does an IHC result take?

Most reports are ready three to five working days after the sample reaches the laboratory. Complex panels may take a little longer.

The tissue has to be fixed, embedded in wax, thinly sliced, and stained with multiple antibodies before a pathologist reads the slide. Each step cannot safely be shortened.

If your report has not arrived after seven working days, ask your care team to follow up.

What do the terms on my IHC report mean?

Positive / negative
Whether the target protein was detected. Both results are informative — a negative rules out diagnoses just as a positive confirms them.
Score: 0, 1+, 2+, 3+
A graded measure of how strongly a protein is expressed. Used most often for HER2. A 2+ result is borderline and usually needs a follow-up test to clarify.
Ki-67
Reflects how actively cells are dividing. Your oncologist reads it alongside all other findings — a high value alone does not determine severity.
ER / PR
Oestrogen and progesterone receptors. Whether positive or negative, these are part of the profile for certain breast and gynaecological cancers.
PD-L1
A protein found on some cancer cells. Its presence and strength are one input into some treatment decisions — not a decision on their own.
CK (Cytokeratin)
A family of proteins that help identify which organ a cancer came from — useful when cancer is found in an unexpected location.

What else should I know about my IHC results?

Why does my report list so many markers?

Each marker answers a different question. Some confirm the cancer type. Some identify the tissue of origin when the starting point is uncertain. Some check for proteins that are relevant to treatment planning. Your oncologist selects the panel based on the initial findings. A longer list of markers reflects a thorough workup — it does not mean the cancer is more advanced.

What does 'equivocal' or 'borderline' mean?

An equivocal result sits in a range that does not give a clear positive or negative answer. This happens most often with HER2 scoring at 2+. The standard next step is a second test called FISH or ISH, run on the same tissue sample. This is not an error in the IHC — it is the intended protocol when a score lands in the borderline zone. Your oncologist will tell you whether that follow-up test applies to you.

Can an IHC result be wrong?

No laboratory test is perfect. False positives and false negatives are uncommon but possible, and can result from tissue quality, how the sample was stored, or variation between laboratories. Using a panel of markers rather than one reduces that risk — results are read together, not in isolation. If the IHC findings do not fit the clinical picture, your oncologist may request a second pathology review of the same slides.

How is IHC different from genetic testing?

IHC shows which proteins are currently being produced in the cancer cells. Genetic or molecular testing reads the DNA or RNA inside the cells to find mutations or gene changes. The two tests answer different questions, and many patients need both. IHC and molecular results are read alongside each other to build a complete picture of the cancer.

Can I read my IHC report without a doctor?

IHC reports are written for pathologists and oncologists. The abbreviations have technical meanings that depend on the cancer type and clinical context — a positive marker means something different in different situations. Bring the report to your appointment and ask your oncologist to go through each result. Writing it down or photographing it before the visit helps you track what was explained.

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Common questions

Frequently asked questions

What is the difference between IHC and a biopsy?

A biopsy is the procedure that collects the tissue. IHC is one of the tests the laboratory runs on that tissue afterwards. You do not need a second procedure. The biopsy sample is processed and stained to produce the IHC report. This is why the report comes days after the biopsy itself — the laboratory preparation takes time and cannot be rushed.

Why does the result take days and not hours?

The tissue has to be fixed in wax, sliced to near-transparency, treated with antibodies, and read by a pathologist who examines each marker individually. A panel covering several markers involves more preparation steps. Shortening any step risks an unreliable result. The timeline exists because the test has to be done correctly, not quickly.

My report says 'no viable tumour'. What does that mean?

It means the pathologist did not find living cancer cells in the section of tissue examined. This can happen if the biopsy captured the edge of a tumour rather than its centre, or if the sample came from an area of dead tissue. Your oncologist will decide whether a repeat biopsy is needed based on this finding and the rest of your clinical picture.

My report has abbreviations I have never seen. Should I be worried?

Not because of the abbreviations alone. IHC reports use technical terms written for pathologists, and an unfamiliar name is not a warning sign. What matters is how your oncologist reads the combination of results in the context of your diagnosis. Bring the report to your appointment and ask for each result to be explained in plain language.

Does IHC show whether cancer has spread?

IHC does not show spread — that is the role of imaging such as CT, MRI or PET-CT. What IHC can do is help identify the tissue of origin when cancer is found in an unexpected location, guiding your team toward the likely primary site. IHC and imaging answer different questions and are used together.

Can I get this workup done at CION?

Yes. CION coordinates the diagnostic workup including pathology across its centres in Telangana and Andhra Pradesh. The IHC staining is processed by specialist pathology laboratories, and the results are reviewed with you by your oncologist at your follow-up. If you had a biopsy elsewhere, ask your care team whether your slides or tissue block can be transferred for review.

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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