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here, the cancer cell is not identified by using only microscopy and then cell based assay is esstenial to identify the cancer cell. cancer cell growth is abnormal. they lack aerobic metabolism.
In a cell culture, it is hard sometimes to see autally if the cells are malignant or not. Some cell types would change their morphology or behaviour. But this might not be an indication that your cells are malignant. If you see cek´ll debris in the cuture or a change in their shape or their doubling time then you can suspect a change has occured to your cells, but they are not necessarily ill. They might have differentiated.Microscopy alone might not be sufficient to tell if cells are malignant or not, but further experiments are needed if you suspect any malignancy.