The first and most important step in treating any tumor is to determine its diagnosis. Only after the correct diagnosis is made can the appropriate treatment be selected.
The process of biopsy and diagnosis is more complex with musculoskeletal tumors than with other types of tumors since many types of tumors can occur in the same body location. This is in contrast with, say, breast cancer where a biopsy is used to detect the presence or absence only of breast cancer.
Sometimes, the diagnosis can be predicted from the patient's history, physical and imaging studies alone. However, when a biopsy is required, it is very important that a specialist guides the process. Without an understanding of the types of tumors that appear at different locations and the range of appearances they can have, a biopsy by itself can be difficult to interpret.
This is why musculoskeletal tumor patients should only undergo biopsy by surgeons who are musculoskeletal tumor specialists.
The Biopsy Technique
Musculoskeletal tumors can start in the bones or the soft tissues and the biopsy technique is different for each.
For soft tissue tumors, a biopsy is performed using a special biopsy needle, often as a simple office procedure.
Bone tumors are usually biopsied as a scheduled procedure by a radiologist using a CT scanner for guidance. Intravenous sedation is used. In certain situations, biopsies are performed as a surgical procedure (“open biopsy”). This is usually when the biopsy remains in question after a needle biopsy.
> An example of bone biopsy being performed under CT guidance
> An example of soft tissue biopsy are performed using a special hollow needle