You strongly suspect a lesion is malignant and have referred the patient for biopsy. What is the MOST appropriate way to explain this to the patient?

Correct answer: D. Explain that the lesion is concerning and could be cancer, and that a biopsy is required to determine what it is

• A. Silent referral leaves the patient without the information needed to appreciate urgency, and patients who do not understand why they are being referred frequently do not attend.
• B. False reassurance is a breach of veracity. It may cause the patient to delay or skip the biopsy, and it destroys trust when the diagnosis returns positive.
• C. Declaring cancer before histological confirmation is factually wrong — clinical impression is not diagnosis — and inflicts avoidable distress. Many clinically alarming lesions prove benign.
• D. CORRECT. This response is both HONEST and ACCURATE about the limits of current knowledge. It conveys the seriousness of the concern — which the patient needs in order to keep the appointment and understand the urgency — without asserting a diagnosis that has not yet been established histologically. It preserves veracity, supports informed decision-making, and leaves room for the genuine possibility of a benign result.

Note: The communication principle: be honest about your level of concern AND honest about your uncertainty. Follow up actively to confirm the patient attended, rather than assuming the referral closed the loop.