What is the initial biopsy type performed for extremity sarcomas if the tumor is less than 4 cm?

The initial biopsy type performed for extremity sarcomas, particularly when the tumor is less than 4 cm, is an excisional biopsy. This method involves the complete surgical removal of the tumor along with a margin of normal tissue. For small tumors, excisional biopsy not only serves as a diagnostic tool but also has the potential benefit of complete tumor removal, which may alter the surgical management of the patient.

In contexts where extremity sarcomas are suspected, excisional biopsy is favored when the tumor is assessable and the surgeon can effectively and safely remove it. This approach allows for accurate histological examination, enabling better characterization of the tumor and staging, which is crucial for the subsequent treatment strategy.

While core needle biopsy and fine needle aspiration are also viable options for sampling tumor tissue, they may not provide sufficient information in some cases, particularly when dealing with sarcomas that require clear definitions of margins and tumor type for effective management. In contrast, incisional biopsy—where only a portion of the tumor is removed—is typically reserved for larger masses or when excision is not feasible due to potential complications or risks associated with larger resections.