How soft tissue sarcomas are diagnosed

You will 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 will usually be seen at the hospital within two weeks.

At the hospital

The specialist will ask about your general health and any previous medical problems. They will also examine you. This 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.

Biopsy

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. It is the only way to tell whether the lump is a cancerous (malignant) or non-cancerous (benign) tumour. You may have other tests and scans to assess the lump before a biopsy. A biopsy can be done as either: 

  • a core needle biopsy
  • a surgical biopsy.

Core needle biopsy

Before the biopsy, the doctor will give you an injection of local anaesthetic into your skin and around your lump to numb it. Then they will pass the biopsy needle through the skin into the lump to take the sample. They use a special needle to do this. They may take several samples.

If the doctor can’t feel the lump or if it is deep within the body, they may use an ultrasound or CT scanner to help them guide the needle into the right place. You will usually be awake during a core needle biopsy, although you may be given a sedative to make you feel more relaxed and drowsy. Sometimes the biopsy is done under a general anaesthetic, particularly for children.

For most people, a core needle biopsy will show whether the lump is cancerous. However, sometimes it doesn’t provide enough cells to give a clear diagnosis. In this case, you will need a surgical biopsy.

Surgical biopsy

This type of biopsy is done less often than a core needle biopsy. A sarcoma specialist will make the decision about whether it should be done. The surgeon uses a surgical knife (scalpel) to open the affected area and remove a sample from the lump. You will be given a local or a general anaesthetic before a surgical biopsy. This depends on your general health, the size of the tumour and how deep it is inside your body.

The samples are then sent to a specialist doctor (pathologist). The pathologist can tell whether the tumour is a cancer or not by examining cells from the sample under a microscope. If it is a cancer, your doctors may do further tests on the sample to find out which type of cancer it is.

I haven’t heard of anyone having one in the same place as me and I know it sounds strange but that makes you feel quite alone in a weird way.

Sarah

Back to How cancers are diagnosed

Further tests

You may need to have further tests if you are diagnosed with a soft tissue sarcoma.