How soft tissue sarcomas are diagnosed
You’ll usually begin by seeing your GP, who will ask you about your symptoms and examine you. They may arrange for you to have tests such as an ultrasound of the lump. You may need to be referred to hospital for these tests and for specialist advice and treatment.
If your GP suspects that you might have a sarcoma, you’ll usually be seen at the hospital within two weeks.
The specialist will ask about your general health and any previous medical problems. They will also examine you, which will include feeling the area where there is pain or swelling. You may be asked to have blood tests and a chest x-ray to check your general health.
The doctors will usually ask if they can take a sample of the lump, which will be examined under a microscope. This is known as a biopsy and is the only way to tell whether the lump is a cancerous or non-cancerous (benign) tumour. You may have other tests and scans to assess the lump before a biopsy. A biopsy can be done in two ways: a core needle biopsy or a surgical biopsy.
Core needle biopsy
This is when a sample of cells is removed from the lump using a needle. Several samples may be taken.
Before the biopsy is taken, a local anaesthetic is injected to numb the area. If the lump is near the surface of your body and can easily be felt, the doctor will probably just feel it to guide the needle in. If the lump is deep within the body (such as in the abdomen) or is harder to feel, the doctor will use an ultrasound scan or sometimes a CT scan to guide the needle into the right place.
A pathologist (a doctor who specialises in diagnosing disease by looking at body tissue and cells) will look at the cells under a microscope to see whether they are benign or cancerous. If the lump is a sarcoma, further tests may be done on the sample to try to find out exactly what type of sarcoma it is.
Sometimes, particularly with children, the biopsy is done under a general anaesthetic while you are asleep.
For most people, a core needle biopsy will show whether the lump is a sarcoma or not. However, sometimes not enough cells are collected to give a clear answer, and then a surgical biopsy is needed.
This is far less commonly used. It will only be done if a core needle biopsy doesn’t give a definite result. A surgical knife (scalpel) is used to open the area and remove a tissue sample from the lump. If the lump is small enough, all of it may be removed.
A surgical biopsy may be done under a local or general anaesthetic, depending on the position of the lump and how deep it is within the body. As with a core needle biopsy, the sample will be sent to the laboratory so that it can be tested. Often a large number of studies will be done even on a very small sample.
It can take up to ten days to get all the results. This can be a worrying time, but it’s very important that an accurate diagnosis is made so that the most appropriate treatment can be given. If the lump turns out to be benign, you may not need to have any more treatment. If it’s cancer, your doctor will discuss the treatment options with you.
Our cancer support specialists can offer you support during this time.