A physician sees the patient for an initial diagnostic evaluation, which typically includes a physical examination, laboratory tests, X-rays and possibly other imaging.

In most cases, cancer specialists can establish a preliminary list of possible diagnoses based on X-rays, bone scans and possibly other radiologic images. To make an accurate diagnosis for bone or soft tissue cancer, a surgical biopsy and analysis of the tumor by a pathologist are needed to determine if it is indeed cancerous and which kind of cancer it is. It may be done in either of the following ways:

Needle biopsy

For this test a small sample of the tumor is taken from the affected area. The sample is then examined under a microscope to identify the exact type of tumor.

Open biopsy

The other way to be certain a tumor is a bone or soft tissue sarcoma is for the doctor to do an open biopsy. This is a minor operation which allows the doctor to take more tissue from the tumor than with the needle biopsy. This is necessary to perform the multiple, complex diagnostic tests required to specifically define diagnostic issues related to the tumor.

For some sarcomas, a piece of tissue from the tumor is sampled initially and pathologists then make a fast-frozen tissue section diagnosis during the operation. When a diagnosis can be made, then the surgeon can proceed and perform the appropriate procedure based on the diagnosis.

Content development for the Bone & Soft Tissue Cancers (Sarcomas) section was supported by the Karen Wyckoff Rein in Sarcoma Fund.