“The Biopsy Was Clear”: When a Pathology Result Is Wrong or Not Followed Up

Missed and delayed diagnosis guides · 13 min read · Published 10 November 2026 · Reviewed 10 November 2026 · Next review May 2027

By Dr Rosemary Listing, PhD (Law) · Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates

If you trusted a biopsy result that turned out to be wrong, or learned that an abnormal result was never passed on, I want you to know that relying on it was entirely reasonable. That is what the test is for.

This guide covers how biopsies and pathology work, the different ways errors happen, what you can ask for, and how the law looks at a pathology error.

Start with your question

• What happens to a biopsy sample?
• What kinds of pathology errors happen?
• Who is responsible for following up a biopsy result?
• What if my result doesn’t match my symptoms?
• Can I get my biopsy slides reviewed?
• What if I had surgery I didn’t need?
• Could a pathology error be negligence?

How a biopsy is examined

A biopsy removes a small piece of tissue or some cells to be examined in a laboratory. A pathologist, a doctor trained in diagnosing disease from tissue, checks the sample. Results are usually ready within a few days.¹

In the laboratory

The tissue is processed into thin slices on glass slides, stained, and examined. The pathologist writes a report describing what they see and giving a diagnosis. For some cancers, the report also includes details that guide treatment, such as how deep the tumour goes or whether the edges are clear.

Where errors happen

• Before the lab: the wrong area is sampled, or the sample is mislabelled or lost. Many pathology errors occur before samples reach the lab.²
• In the lab: a cancer is missed on the slide (a false negative), something benign is called cancer (a false positive), or important details are wrong.
• After the lab: a correct, abnormal result is not seen, not acted on, or not passed on to you.

Australia has experience of large-scale pathology error. A 2012 study described a look-back in which independent pathologists reviewed more than 7,000 cases reported by one pathologist and found clinically significant errors in almost 3%.³

Getting your results

healthdirect says the doctor who ordered the test is the best person to interpret it, and that your doctor is responsible for explaining results and recommending next steps.² A text message saying “normal” may be all you get, but you are entitled to the report itself.

Questions to ask about a biopsy result

• Can I have a copy of the pathology report?
• Was the whole lesion removed, and are the edges clear?
• Does this result fit with my symptoms and what you saw?
• Is any follow-up or repeat test needed?

When results aren’t followed up

Some of the most serious problems aren’t misread slides at all. They are correct reports showing something abnormal that sat in an inbox, were filed without being read, or were sent to a doctor who had moved on. Clinics are expected to have systems for tracking results and recalling patients.

When a result doesn’t fit

A biopsy result is one piece of evidence. If it says “benign” but the lump keeps growing, or symptoms continue, a doctor should question the result rather than rely on it. Our guide to getting a second opinion explains how.

Second review of slides

Slides and tissue blocks are kept by the laboratory, and they can be reviewed by another pathologist. If your diagnosis changes, or you are unsure about a result, your doctor can ask for a review. That review is often the clearest evidence of whether an error was made.

When the result was wrong the other way

A false positive can mean surgery, chemotherapy or radiotherapy that wasn’t needed, with its own lasting effects. If later testing shows you never had cancer, ask how the original diagnosis was made.

See also our guides to late bowel cancer diagnosis and failed diagnosis.

What to look for in the records

Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.⁴ Our step-by-step guide to getting your medical records in Australia walks you through it.

How the law looks at it

A pathology result that turns out to be wrong is not automatically negligence. Some cancers are genuinely hard to see, and pathologists can reasonably disagree on borderline cases. The legal questions are whether the pathologist, the laboratory and the treating doctor met the standard expected, and whether any shortfall caused harm.

A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))⁵, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)⁶, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)⁷⁸. Our guide to how a medical negligence claim works explains each one in plain terms.

In a pathology case, the questions might be: was the sample taken from the right place and labelled correctly? Would a competent pathologist have seen the abnormality? Was clinical information given to the lab? Was the result received, read and acted on? Were you told the result and what it meant? Did anyone question a result that didn’t fit?

In plain terms, the question is whether an accurate, followed-up result would probably have led to earlier treatment and a better outcome, or avoided treatment you didn’t need.

For a biopsy, the relevant information is usually about what the result means and what follow-up is needed.

Who can claim, and when

The patient can claim. If they have died, their family may have a claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.

More: complaint or claim? · how a claim is paid for · what a claim can cover

In my practice

In pathology files, the slides are often the key. A review by an independent pathologist can show clearly whether something was there to be seen. Just as often, though, the report was right and the problem was what happened next: an abnormal result filed without action, or a “normal” text that left out the important detail. Following the result from lab to patient usually shows where it went wrong.

Both things can be true

The pathologist and your doctor may have been careful and competent, and an error may still have happened. You can trust the system in general and still want to know what went wrong in your case.

The bigger picture

Pathology laboratories in Australia are accredited, and large-scale errors have led to formal look-backs.³ Complaints about care in NSW can go to the Health Care Complaints Commission,⁹ and you can check a practitioner’s registration on the Ahpra public register.¹⁰ Our guide to getting your medical records explains how to ask for reports.

Our missed and delayed diagnosis page brings together related guides.

Support

You don't have to work through this alone. These services can help:

• Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)¹¹
• Beyond Blue, anxiety and depression support: 1300 22 4636
• Medicare Mental Health, help finding mental health support: 1800 595 212
• healthdirect, 24-hour nurse advice: 1800 022 222
• Health Care Complaints Commission (NSW): 1800 043 159

A woman who was told “normal, no follow-up needed” now knows what the slides really showed. You deserve that truth too.

With care,
Rosemary

Frequently asked questions