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Confidence in fine needle aspirate diagnosis?
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29 September 2017
2:54 pm
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My cat Raven was diagnosed with soft tissue sarcoma in her left rear leg with a fine needle aspirate test.  She is scheduled for amputation on Monday, 2 Oct.

It was mentioned the cancer was likely a vaccine-associated sarcoma, which has an incidence of 1 in 10,000 vaccinated cats. Initially, the rarity of the cancer gave me extreme concern about the error rate of the diagnosis.  After a little more education, I've gained more confidence in the diagnosis, but still agonize about relying on a fine needle aspirate result as the sole determinant for amputating my cat's leg.  Even if the error rate is very small, it is a big concern given the radical intervention path we're on.  I can't imagine a result more devastating than a post-op biopsy result that didn't agree with our fine needle aspirate diagnosis.

Like so many others on this site, I'm trying to do what's best for my pet.  If there are any veterinarians reading this that could give me more confidence in proceeding with amputation based on a fine needle aspirate test alone, I sure would appreciate it.  I'm left wondering how often post-amputation biopsy disconfirms fine needle aspirate results.  

   

29 September 2017
3:54 pm
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Welcome and best wishes for Raven! Your future forum posts will not require moderation.

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30 September 2017
2:20 pm

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If there are sarcoma cells on the aspirate then surgery is the best option.  For vaccine induced fibrosarcoma it can be hard to get full margins without amputation so that is usually the best choice.  Other sarcomas may be resected with smaller margins so it depends where the tumor is and how big it is.

Your vet could biopsy the center of the lesion to confirm the sarcoma type prior to surgery or the limb can be sent for biopsy after the amputation has been done.

If your vet thinks that amputation would remove the entire mass then I would just do that.  If he thinks that the tumor might persist beyond normal surgical margins (fibrosarcoma can be quite expansive) then it is best to do a biopsy to confirm tumor type and then a CT scan prior to surgery.

Pam

30 September 2017
7:16 pm
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Thanks for the response, Pam.

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