Diagnosis of soft tissue sarcoma

Diagnosis is the process of finding out the cause of a health problem. Diagnosing cancer often means first ruling out other health conditions that share similar symptoms with cancer. It can be a very worrying time for you and your loved ones. Sometimes this process is quick. Sometimes it can feel long and frustrating. But itʼs important for doctors to get all the information they need before making a diagnosis of cancer.

Diagnosing soft tissue sarcoma usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor will refer you to a specialist or order tests to check for soft tissue sarcoma or other health problems.

The following tests are usually used to rule out or diagnose soft tissue sarcoma. Many of the tests that are used to diagnose cancer are also used to find out the stage (how much cancer there is or where itʼs located). Your doctor may also order other tests to check your general health and to help plan your treatment.

Your health history is a record of your symptoms and risks and all the medical events and problems you have had in the past. Your doctor will ask questions about your history of:

• signs or symptoms that suggest soft tissue sarcoma
• radiation therapy
• chronic lymphedema
• certain inherited conditions that increase your risk for soft tissue sarcoma, such as neurofibromatosis type 1

Your doctor may also ask about a family history of:

• soft tissue sarcoma
• retinoblastoma
• other cancers in young family members

A physical exam allows your doctor to look for any signs of soft tissue sarcoma. During a physical exam, your doctor may:

• check for a lump or swelling on your body
• look at how much a leg, arm or joint can move
• check the lungs
• feel the abdomen for an enlarged liver

Find out more about a physical exam.

An ultrasound uses high-frequency sound waves to make images of parts of the body. It may be used to find out if a lump is a fluid-filled cyst or a solid tumour.

Find out more about an ultrasound.

Magnetic resonance imaging (MRI) uses powerful magnetic forces and radiofrequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer program turns the images into detailed pictures.

An MRI is used to:

• help find out if a tumour is cancerous (soft tissue sarcoma) or non-cancerous (benign soft tissue tumour)
• find out which kind of soft tissue sarcoma (subtype) it is
• find out the location of the tumour
• check the size of the tumour
• check if the cancer has spread

It’s often the first imaging test done for lumps in the arms or legs.

Find out more about MRIs.

A computed tomography (CT) scan uses special x-ray equipment to make 3D and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer program turns the images into detailed pictures.

A CT scan is used to:

• help find out if a tumour is cancerous (soft tissue sarcoma) or non-cancerous (benign soft tissue tumour)
• find out which kind of soft tissue sarcoma (subtype) it is
• find out the location of the tumour
• check the size of the tumour
• check if the cancer has spread

Itʼs often used to check for tumours in the abdomen and in the chest.

Find out more about a CT scan.

A biopsy is necessary to diagnose and find out the type of soft tissue sarcoma. During a biopsy, the doctor removes tissues or cells from the body so that they can be tested in a lab. A report from a pathologist will show whether or not cancer cells are found in the sample. If cancer is diagnosed, the report will also show the type of cancer and grade of the tumour.

The type of biopsy used depends on where the lump is and its size.

A core biopsy uses a hollow needle or probe to remove a piece of tissue so it can be examined under a microscope. It’s a common type of biopsy used to diagnose soft tissue tumours. Sometimes an imaging test, such as a CT scan or ultrasound, may be used to guide the needle to the tumour. This technique is called an image-guided biopsy. Find out more about a core biopsy.

A surgical biopsy removes tissue from a lump or removes an entire lump during surgery. It’s a common type of biopsy used to diagnose soft tissue tumours.

An endoscopic biopsy removes tissue from a lump or removes an entire lump during an endoscopy. It may be done when the lump is deep within the body, such as in the abdomen.

Find out more about a biopsy.

A bone scan uses bone-seeking radioactive materials called radiopharmaceuticals and a computer program to create a picture of the bones. It’s used to check if soft tissue sarcoma has spread to the bone.

Find out more about a bone scan.

An x-ray uses small amounts of radiation to make an image, on film, of parts of the body. It may be used to check if soft tissue sarcoma has spread to the lungs.

Find out more about x-rays.

Find out more about a diagnosis. To make the decisions that are right for you, ask your healthcare team questions about diagnosis.