timing

Principles of Biopsy

Aims

 

1.  Provide representative sample

- to determine whether benign or malignant

- to determine cell line

- to grade lesion

 

2.  Not compromise definitive treatment

 

Timing

 

Last step in evaluation / after staging

 

Don't perform definitive procedure immediately after biopsy unless

- pre-operative & Xray information characteristic

Chemotherapy

Sensitivity

 

High grade tumours often sensitive to intensive chemotherapy

- OS

- Ewings

- MFH

 

Low grade often insensitive 

- Chondrosarcoma

- Parosteal OS 

 

Role

 

1.  Eradication of overt & micrometastasis

- OS 80% have micrometastasis

 

2.  Reduce tumour locally 

- makes limb salvage easier

 

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