Diagnosing Soft Tissue Sarcoma

If soft tissue sarcoma is suspected, your doctor will examine you and ask you about medical history, including any symptoms you may have. You may also have one of the following tests to diagnose the disease.

Biopsy

In a biopsy, a physician removes a small sample of cells from the tissue to be analyzed under a microscope for signs of cancer. There are several ways to obtain a biopsy sample for diagnosing soft tissue sarcoma:

Incisional Biopsy

The doctor removes a tissue sample during a surgical procedure.

Needle Biopsy

The doctor uses a needle to remove a small sample of tissue. There are two types of needle biopsy: Fine and Core. Core uses a wider needle than Fine needle biopsy.

Excisional Biopsy

A surgeon removes an entire lump or area of abnormal tissue.

Removed tissue will undergo other tests following the biopsy procedure to help the OSUCCC – James experts classify the type and subtype of soft tissue sarcoma. These tests include:

Immunohistochemistry

This test uses dye on proteins called antibodies to identify certain antigens in the tissue sample. Antigens are any substance that causes a response in the body’s immune system against that substance. Antigens include toxins, bacteria, chemicals, viruses or other substances that come from outside the body.

Light & Electron Microscopy

Changes in cells that indicate cancer types are evaluated under high-powered microscopes.

Cytogenetic Analysis

This test analyzes the cells to identify changes in the chromosomes.

Fluorescence in Situ Hybridization (FISH)

This laboratory test analyzes the cells’ genes or chromosomes. A special light and fluorescent dye cause certain genes or specific areas of chromosomes to light up when pieces of lab-created DNA attach to them.

Flow Cytometry

Flow cytometry measures numbers and proportions of cells in a tissue sample and can determine characteristics of cells, such as their shape, size and presence of tumor markers. Tumor markers are substances that indicate certain cancers.

Tests Used to Stage Soft Tissue Sarcoma

Identifying soft tissue sarcoma stages helps determine how much cancer is present your body, the size and grade of the tumor, whether or not the cancer has spread, and if so, where it has spread. Staging is just one of many ways that the OSUCCC – James soft tissue sarcoma cancer experts plan the most targeted, accurate way to treat your specific cancer.

The OSUCCC – James experts will order tests to help stage soft tissue sarcoma. These tests include:

Physical Exam

Your OSUCCC – James physician will ask questions about your health history as well as examine your body for additional lumps or signs of disease and determines your overall health.

Chest X-ray

This exam uses X-rays to produce images of the organs and bones inside your chest, especially the lungs.

Computed Tomography Scan (CT)

A CT scan is an X-ray that produces detailed, cross-sectional images of the body.

Magnetic Resonance Imaging (MRI)

MRI uses a high-powered magnet and radio waves to capture high-resolution, detailed images of the body.

Positron Emission Tomography (PET)

A PET scan is an imaging examination used to find malignant tumor cells in the body. The specialists inject a small amount of radioactive glucose (sugar) into a vein, then use a specialized scanner that rotates around your body to take detailed pictures of where the glucose gathers in high amounts. Cancer cells absorb more glucose than normal cells.

(Source: National Cancer Institute)

Soft Tissue Sarcoma Stages

The staging classification remains the same throughout treatment. Soft tissue sarcoma stages include: 

Stage I

Stage I is divided into stages IA and IB:

Stage IA

  • The tumor is low grade, which means it is likely to grow and spread slowly, and it is less than 5 centimeters. 
  • It may be either superficial (in subcutaneous tissue, which is tissue beneath the skin, and has not spread into the muscle below) or deep (in the muscle structures in the deeper parts)

Stage IB

  • The tumor is low grade (which means it is likely to grow and spread slowly), and it larger than 5 centimeters. 
  • It may be either superficial (in subcutaneous tissue, which is tissue beneath the skin, and has not spread into the muscle below) or deep (in the muscle structures in the deeper parts)

Stage II

Stage II is divided into stages IIA and IIB:

Stage IIA

  • The tumor is mid-grade (somewhat likely to grow and spread quickly) or high grade (likely to grow and spread quickly), and it is 5 centimeters or smaller.
  • It may be either superficial (in subcutaneous tissue, which is tissue beneath the skin, and has not spread into the muscle below) or deep (in the muscle structures in the deeper parts)

Stage IIB

  • The tumor is mid-grade (somewhat likely to grow and spread quickly), and it is larger than 5 centimeters. 
  • It may be either superficial (in subcutaneous tissue, which is tissue beneath the skin, and has not spread into the muscle below) or deep (in the muscle structures in the deeper parts)

Stage III

The tumor is either:

  • High grade (likely to grow and spread quickly), larger than 5 centimeters and either superficial (in subcutaneous tissue, which is tissue beneath the skin, and has not spread into the muscle below) or deep (in the muscle structures in the deeper parts); or
  • Any grade, any size and has spread to nearby regional lymph nodes

Stage III cancer that has spread to nearby lymph nodes is advanced stage III.

Stage IV

The tumor is any grade, any size and may have spread to distant lymph nodes . Cancer has spread to distant parts of the body, such as the lungs.

(Source: National Cancer Institute)

If you’ve been diagnosed with soft tissue sarcoma, would like a second opinion or would like to speak with a sarcoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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Patient Story

Patient Stories Bill Mason

Bill Mason

Bill Mason thought the lump in his back thigh was just a strained muscle. Finding out instead that it was a rare, soft tissue sarcoma, he found the specialty and expertise he needed to heal at the OSUCCC...

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