Newly Diagnosed?
We Can Help Getting the correct diagnosis and the most appropriate treatment from the start is crucial 
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Memorial Sloan-Kettering doctors lead the world in characterizing sarcomas molecularly and genetically, making accurate diagnoses more common. Our researchers have pioneered the molecular diagnosis of many sarcoma subtypes and are leading the search for genetic markers that may help determine the aggressiveness of tumors and their potential response to treatment.
Medical History & Physical Examination
Doctors use medical history and physical examination to find out your symptoms and risk factors, as well as to get a picture of your general health and other information about signs of sarcoma.
Imaging Studies
Imaging studies to identify masses are crucial to good clinical management.
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Ultrasonography
Because sound waves are reflected differently off of tumors than normal tissues, ultrasound can sometimes identify a mass for biopsy.
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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, PET/CT (positron-emittance tomography and computed tomography) is now often a combined study. Combination PET/CT shows both the location and the metabolic signal of actively growing cancer cells if a tumor should arise. If the PET/CT study indicates a recurrence, your doctor may order a separate CT study for precise information about the location of the tumor.
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Magnetic Resonance Imaging (MRI)
This process is similar to a CT scan but employs large magnets and radio waves to produce the 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 the need for 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 growth. Biopsy also enables doctors to determine the type of sarcoma and its grade -- a predictor of the risk of 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.
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Fine Needle Aspiration Biopsy
In fine needle aspiration biopsy, a doctor uses a fine needle and a 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. 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.
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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 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 need an incisional biopsy.
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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 of the extremities. The procedure is less invasive and less painful for the patient and results in a more rapid answer than incisional biopsy.
Diagnosis: The Next Phase
In the near future, thanks to advances in molecular and genetic technology, pathologists should be able to know which drugs will be effective against the molecular make-up of a particular tumor.
