Sarcoma Diagnosis

Imaging tests can provide useful insights into the presence and location of a mass. Imaging tests can help identify both benign and cancerous tumors.

Some common imaging studies used for sarcoma diagnosis include:

• Ultrasound: These tests use sound waves to detect and visualize masses within the human body. They may also potentially guide a biopsy procedure.
• CT Scan: These tests take multiple X-ray images of the affected site from different angles, creating detailed cross-sectional views of your body. CT scans are often combined with a PET scan (PET/CT) for follow-up to show both the location and activity of cancer cells.
• MRI Scan: Magnetic Resonance Imaging (MRI) is similar to a CT scan but uses magnets and radio waves to produce detailed images, including blood vessel structures in the body. MRIs can help measure the tumor’s size and can help determine whether a sarcoma can be removed by surgery.

While imaging tests may identify the possible existence of sarcoma, a biopsy test is typically the most definitive step for diagnosis and identifying the specific type of sarcoma you may have. 

Soft tissue sarcomas are some of the rarest types of cancer, and proper diagnosis requires an experienced pathologist with expertise in analyzing these specific cancers. At Sarcoma Oncology Center, we prioritize proper biopsy procedures performed by sarcoma specialists to ensure optimal outcomes.

During a biopsy, a small tissue sample is removed from the suspected tumor for microscopic examination by a pathologist. This procedure is crucial for confirming a sarcoma diagnosis and determining the type and grade (aggressiveness) of the cancer. A biopsy allows a pathologist to definitively confirm the presence of sarcoma and differentiate it from other conditions.

Types of biopsies include:

• Fine Needle Aspiration (FNA): This is a minimally invasive procedure where the doctor uses a fine needle and syringe to remove tiny pieces of the tumor for microscopic examination. This procedure is sometimes used to determine if a suspicious mass is a benign tumor or cyst. In some cases, the mass can indicate an infection or some other disease. If examination of the cells indicates sarcoma, incisional biopsy or core needle biopsy may be required to confirm the diagnosis and determine the aggressiveness (grade) of the cancer.
• Incisional Biopsy: This is a surgical procedure where a surgeon removes a portion of the tumor for further analysis. An incisional biopsy is usually an outpatient procedure with general or local anesthesia. Previously, almost all patients with soft tissue sarcoma in the extremities had to undergo an incisional biopsy before treatment. Today, less than one-third need an incisional biopsy.
• Core Needle Biopsy: This is a minimally invasive procedure using a larger needle to extract a cylindrical tissue sample. This is an outpatient procedure performed under local anesthesia, allowing patients to go home on the same day. Memorial Sloan-Kettering doctors have found that core needle biopsy is as effective as incisional biopsy in diagnosing soft tissue sarcoma of the extremities. This procedure is less invasive and less painful for the patient and generates quicker results than an incisional biopsy.

Following the biopsy, tissue samples may undergo additional laboratory testing to identify specific genetic markers or protein expressions unique to your sarcoma. Understanding these characteristics helps tailor your treatment plan, offering a more personalized approach.