Support Services We understand that life is different after a cancer diagnosis 
|
|
|
Physicians use several kinds of tests to diagnose soft tissue sarcoma. These tests help determine your exact type of sarcoma and uncover other features that are helpful in deciding on the most effective course of treatment.
Imaging studies to identify masses are crucial to good clinical management.
-
Ultrasonography
Because sound waves are reflected differently off tumors than normal tissues, ultrasound can sometimes identify a mass for biopsy.
-
Computed Tomography (CT)
X-ray images are taken of the body from different angles, and then combined by a computer, producing a cross-section picture of the inside of the body. For surveillance during follow-up, CT/PET (computed tomography and positron-emittance tomography) is now often a combined study at Memorial Sloan-Kettering. Combination CT/PET shows both location and activity if a tumor should arise. If the CT/PET study indicates a recurrence, your doctor may order a separate CT study for precise information about the location of the tumor.
-
Magnetic Resonance Imaging (MRI)
This process is similar to a CT scan but employs large magnets and radio waves to produce images. One advantage of MRI over CT scan is MRI's capability to show blood vessels in greater detail and to picture cross-sections from multiple angles.
Biopsy
In a biopsy, the surgeon removes a sample of the tissue from the tumor so that it can be examined microscopically by a pathologist. In some situations, signs or results of imaging studies are so clear as to indicate surgery before biopsy. Even in these situations, biopsy is performed on excised tissue to be sure the tumor is a sarcoma and not another type of cancer or a noncancerous disease.
Biopsy also enables doctors to determine the type of sarcoma and its grade -- a predictor of the risk of it spreading (metastasis). In the past decade, the genes mutated in many soft tissue sarcomas have been identified, allowing for accurate diagnoses based on molecular makeup. Much of the work contributing molecular genetic data to the classification of sarcomas is being pioneered at Memorial Sloan-Kettering.
-
Fine Needle Aspiration Biopsy
In fine needle aspiration biopsy, a 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 actually a benign tumor or cyst, or attributable to an infection or some other disease besides cancer. If examination of the cells indicates sarcoma, incisional biopsy or core needle biopsy may be required to confirm the diagnosis and determine the type of aggressiveness (grade) of the cancer.
-
Incisional Biopsy
In an incisional biopsy, a surgeon cuts through the skin to remove part of a tumor, which is then examined microscopically. An incisional biopsy usually involves a one-day hospital admission, with general or local anesthesia. Previously, almost all patients with soft tissue sarcoma in the extremities had to undergo incisional biopsy prior to treatment. Today, less than one-third of patients need an incisional biopsy since less invasive procedures, such as core needle biopsy, have been developed.
-
Core Needle Biopsy
In core needle biopsy (also known as Tru-Cut® biopsy), a surgeon removes a cylindrical tissue sample about 1.5 millimeters across. This is an outpatient procedure, performed under local anesthesia, which allows patients to go home immediately afterwards. Memorial Sloan-Kettering doctors have found that core needle biopsy is as effective as incisional biopsy in making a diagnosis of soft tissue sarcoma in the arms and legs. The procedure is less invasive and less painful for the patient, and yields faster results than incisional biopsy.
