Choice of site
- Stay in compartment
- Plan later surgery incision
- Avoid reactive bone / necrosis
Biopsy is only done once the magnetic resonance and other imaging studies are over. The principle of biopsy is to use a direct approach to the lesion. The incision must be in the line if incision for of future planned procedures such as a block excision. Drains must come out of the wound or also exit in the line of this planned surgery. Avoid textbook approaches as they invariably open up new fascial compartments. Chose a viable part of the tumor and avoid ' triangle.
Whether you use a open approach or a needle (Coombs) biopsy depends to a large extent on the expertise of the pathology department and how much other supportive evidence you have about the diagnosis.