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Tests and diagnosis
By Mayo Clinic staffIf it's suspected that you have sarcoma, your doctor will take a medical history, perform a physical exam and may also remove a sample of tissue (biopsy) from the tumor for examination. Techniques for biopsy of a suspected soft tissue sarcoma include:
- Needle biopsy. Your doctor uses a thin needle to remove small pieces of tissue from the tumor. There are two types of needle biopsy — fine-needle aspiration and core biopsy. A core biopsy involves using a slightly larger needle to remove a small, solid core of tissue.
- 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). In some cases you may need only local anesthesia. For a larger or deep-seated tumor, you'll likely require general anesthesia for the procedure. It's important that a doctor experienced in the treatment of sarcomas perform the excisional biopsy.
Imaging tests, such as X-rays, computerized tomography (CT) scans, ultrasound, magnetic resonance imaging (MRI) and positron emission tomography (PET), also may be done to enable your doctor to see and evaluate the area of concern.
Grading and staging
Besides determining whether it is malignant, examining tissue can determine how aggressive the cancer is (its grade). Further testing, such as with imaging scans and blood tests, can help determine if the cancer has spread and, if so, how far (its stage).
- Stage I. These tumors are generally small, but what's important is that the tissue cells appear normal. Additionally, the sarcoma hasn't spread to the lymph nodes or to distant sites.
- Stage II. In more advanced soft tissue sarcomas, the cells begin to look abnormal and they may be dividing rapidly. At this stage, however, it still hasn't spread to the lymph nodes or other areas of the body.
- Stage III. Not only do the cells look abnormal and divide rapidly, malignant cells are found in one or more lymph nodes.
- Stage IV. At this stage, the cells are abnormal and rapidly dividing, and the cancer can be found in the lymph nodes and in other parts of the body.
- DeLaney TF. Overview of soft tissue sarcoma. http://www.uptodate.com/index/home.html. Accessed July 10, 2009.
- Detailed guide: Sarcoma - Adult soft tissue cancer. American Cancer Society. http://documents.cancer.org/188.00/188.00.pdf. Accessed July 10, 2009.
- Soft tissue sarcomas: Questions and answers, National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/soft-tissue-sarcoma. Accessed July 29, 2009.
- Adult soft tissue sarcoma treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/adult-soft-tissue-sarcoma/healthprofessional/allpages/print. Accessed July 27, 2009.
- Moynihan TJ (expert opinion). Mayo Clinic. Rochester, Minn. Aug. 2, 2009.
