Tests and diagnosisBy Mayo Clinic staff
What imaging tests you undergo depends on your situation. Your doctor may recommend one or more imaging tests to evaluate the area of concern, including:
- Bone scan
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
Removing a sample of tissue for laboratory testing
Your doctor may recommend a procedure to remove (biopsy) a sample of tissue from the tumor for laboratory testing. Testing can tell your doctor whether the tissue is cancerous and, if so, what type of cancer you have. Testing may also reveal the cancer's grade, which helps doctors understand how aggressive the cancer may be.
Types of biopsy procedures used to diagnose bone cancer include:
- Inserting a needle through your skin and into a tumor. During a needle biopsy, your doctor inserts a thin needle through your skin and guides it into the tumor. The needle is used to remove small pieces of tissue from the tumor.
- Surgery to remove a tissue sample for testing. During a surgical biopsy, your doctor makes an incision through your skin and removes either the entire tumor (excisional biopsy) or a portion of the tumor (incisional biopsy).
Determining the type of biopsy you need and the particulars of how it should be performed requires careful planning by your medical team. Doctors need to perform the biopsy in a way that won't interfere with future surgery to remove bone cancer. For this reason, ask your doctor for a referral to an appropriate surgeon before your biopsy.
Tests to determine the extent (stage) of the bone cancer
Once your doctor diagnoses your bone cancer, he or she works to determine the extent (stage) of your cancer. The cancer's stage guides your treatment options.
Stages of bone cancer include:
- Stage I. At this stage, bone cancer is limited to the bone and hasn't spread to other areas of the body. After biopsy testing, cancer at this stage is considered low grade and not aggressive.
- Stage II. This stage of bone cancer is limited to the bone and hasn't spread to other areas of the body. But biopsy testing reveals the bone cancer is high grade and considered aggressive.
- Stage III. At this stage, bone cancer occurs in two or more places on the same bone. Biopsy testing shows this bone cancer is high grade and considered aggressive.
- Stage IV. This stage of bone cancer indicates that cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs.
- Gebhardt MC, et al. Sarcomas of bone. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008:1945.
- Bone cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed June 29, 2011.
- Bone cancer: Questions and answers. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/bone. Accessed June 29, 2011.