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A biopsy using a small needle with a hollow core creates fewer side effects and appears to be just as accurate as an open biopsy for the diagnosis of sarcomas, according to a recent article published in the journal Cancer.

There are 2 types of sarcomas: soft-tissue sarcomas and sarcomas of the bone. Soft-tissue sarcomas are characterized by the growth of cancer cells in the soft tissue of the body. Soft tissues include muscles, tendons, fibrous tissue, fat, blood or lymph vessels, nerves or the tissues around joints. Treatment for sarcomas varies, depending on the specific type of cancer, the place in the body where the cancer started, and the extent of the disease.

Controversy exists over the optimal diagnostic method for masses present in soft tissue or bone. Currently, the majority of biopsies used to diagnose sarcomas are called

open incisional biopsies. This procedure involves a wide incision through the skin in order to expose the suspicious mass so that a tissue sample can be removed and analyzed in a laboratory. An open incisional biopsy is associated with a 16% complication rate. Over 8% of patients who undergo an open incisional biopsy have their cancer treatment affected by these complications. Moreover, 1.2% of all patients who have an open incisional biopsy undergo an unnecessary amputation due to diagnostic errors.

Fine needle aspiration biopsy (FNAB) is another type of biopsy in which a very fine needle is placed into the mass for the collection of a cell sample. However, an adequate number of cells is difficult to obtain through FNAB, often times resulting in the need for a patient to undergo a repeat biopsy.

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The percutaneous core needle biopsy is a procedure in which a small needle with a hollow core is used. The needle is placed into the suspicious mass and a tissue sample is collected. The hollow core is large enough for an adequate tissue specimen to be collected. Researchers from the Washington Cancer Institute recently conducted a clinical trial to evaluate the accuracy and safety of percutaneous core needle biopsies when used for diagnostic purposes involving masses of the muscle or bone.

In this clinical trial, 173 percutaneous needle biopsies were performed. Following these biopsies, patients either underwent surgical removal of the mass or an open incisional biopsy in order to confirm results. The complication rate of the percutaneous needle biopsies was 1.1%. None of these complications affected the patients’ cancer treatments. Patients who underwent a percutaneous needle biopsy experienced fewer major diagnostic errors than the overall average of diagnostic errors reported from open incisional biopsies.

These results indicate the safety and accuracy of percutaneous needle biopsies for the diagnosis of sarcomas. Patients who have been advised to undergo a biopsy for a suspicious mass of the muscle or bone may wish to speak with their physician about the risks and benefits of a percutaneous needle biopsy or about the participation in a clinical trial further evaluating this procedure.

(Cancer, Vol 89, No 12, pp 2677-2686, 2000)

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