Clinical studies undertaken by the Musculoskeletal Tumor Society have documented a high incidence of problems suffered by patients who have been biopsied in medical centers that do not specialize in bone tumor management.
- It is likely that patients with primary malignant or aggressive bone tumors are best biopsied by musculoskeletal surgical oncologists.
- Patients with probable metastatic tumors likely do not require this level of sub-specialty care, and biopsies performed to confirm metastatic disease are usually done by general orthopaedic surgeons.
Prior to deciding whether to do a biopsy, the surgeon should ask, "Is there a chance that this is a primary aggressive or malignant bone tumor?" If the answer is yes, or if the clinician is not certain as to the probable diagnosis, the patient should be referred prior to biopsy.
