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Tests for soft tissue sarcoma

Men and woman discussing soft tissue sarcomas

This page tells you about tests you may have to diagnose soft tissue sarcoma. There is information about

 

A quick guide to what's on this page

Tests for soft tissue sarcoma

Usually you begin by seeing your family doctor, who will examine you and ask about your general health. The doctor will feel the area where there is pain or swelling. It may feel tender or it may be possible to feel a lump. Your doctor may need to refer you to hospital for tests and X-rays. Or they may refer you directly to a specialist.

At the hospital

Your specialist will ask you about your medical history and symptoms. They will then examine you by feeling the area that is painful or swollen. They may ask you to have blood tests and a chest X-ray to check your general health.

You usually have an MRI scan to show the size and exact position of the lump. Depending on where it is in the body you may also have X-rays of the area or a CT scan

Your specialist will then usually take some samples of cells from the lump. They call this a core needle biopsy. You usually have a local anaesthetic first to numb the area. If the lump is deep in the body your doctor may use an ultrasound scan or CT scan to make sure that the needle is in the right place.

If the lump is large and close to the surface of the body your doctor may remove some tissue from the lump using a surgical biopsy. They may remove the whole lump and this is called an open biopsy. You may have these biopsies under local anaesthetic or general anaesthetic.

The doctor sends the biopsy samples or the lump to the laboratory where a pathologist looks at the cells under a microscope. They can then see if they are sarcoma cells.

In some specialist hospitals doctors use a method called a fine needle aspiration to get a sample of cells. They put a very fine needle into the lump and suck out some cells. But this is not very used very often.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Diagnosing soft tissue sarcoma section.

 

 

At the GP

Usually you begin by seeing your family doctor who will examine you and ask about your general health. Your doctor will ask you about your symptoms. This will include what they are, when you get them and whether anything you do makes them better or worse.

Your doctor will do a physical examination. They will feel the area where there is pain or swelling. It may feel tender, or it may be possible to feel a lump. After your examination, your doctor may need to refer you to hospital for tests and X-rays or you may be referred directly to a specialist in a hospital that has teams that diagnose and treat sarcoma.

 

At the hospital

If you see a specialist, you will be asked about your medical history and symptoms. The specialist will then examine you by feeling the area that is painful or swollen. You may be asked to have blood tests and a chest X-ray to check your general health. Then your tests will be arranged in the outpatient department.

 

MRI scan

You usually have an MRI scan. This uses magnetic fields to build up a picture of body tissues and structures. Soft tissue shows up more clearly on this scan than on other types of scan. It is a very useful test for soft tissue sarcoma and can show the size and position of the lump. There is detailed information on our page about MRI scans.

After this scan your doctor will usually take a sample of cells from the lump. If the lump is small they may take several core needle biopsies. If the lump is larger than 5cm and close to the skin a surgical biopsy may be the best option.

 

X-rays or CT scans

You may also have X-rays or a CT scan depending on where the lump is.  In some areas of the body these tests can give extra information about the size and shape of the tumour and whether it is likely to be a cancer.

 

Core needle biopsy

A core needle biopsy takes a sample of cells from the lump. The doctor uses a needle with a special cutting tool on the end. You usually have more than one biopsy taken. You will have a local anaesthetic injection to numb the area before the doctor puts the needle in. 

If the lump is near the surface of your body and easy to get to, the doctor will probably just feel it to guide the needle in. If the lump is deeper or harder to feel, the doctor will use an ultrasound scan or CT scan to see where the needle is going and guide it to the right place. The doctor puts the samples of tissue into a small pot. They send them to the laboratory so that they can be examined under the microscope to look for cancer cells.

This procedure can be uncomfortable and your doctor may prescribe mild painkillers for you. If the lump turns out to be non cancerous (benign) you may not need any more treatment. If it is cancer, your doctor will talk over the treatment options with you.

 

Surgical biopsy

A surgical biopsy is usually done if a core biopsy has not given a definite result or if the lump is deep in the body. Surgical biopsy means using a surgical knife (scalpel) to open the area and take a tissue sample from the lump. Or, if the lump is small enough, the surgeon may remove it completely. This is called an excision biopsy. Depending on the scale of the biopsy operation, you may have this done under local anaesthetic or general anaesthetic.

 

Fine needle aspiration (FNA)

FNA is used in some specialist hospitals. FNA means putting a thin needle into the lump to take a sample of cells. If the lump is near the surface of your body and easy to get to, the doctor will probably just feel it to guide the needle in. If the lump is deeper or hard to feel, the doctor will use an ultrasound scan or CT scan to guide the needle into the right place. 

The doctor sucks out some fluid from the lump into a syringe. The fluid will contain cells. This procedure is usually no more uncomfortable than a blood test but if you prefer, you can have a local anaesthetic injection before the needle aspiration.

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Updated: 9 February 2015