Diagnosis of melanoma is most often done by a simple skin exam. The exam should be thorough, as melanoma can occur in any part of the skin. Some tools can aid in the diagnosis, such as magnification or special types of light, and photographs are often helpful for follow up exams of the skin over time. The most important part of the evaluation, though, is the experience of the examiner and the dedication to doing a thorough job. Most often, this is done by a dermatologist or primary care physician, and when in doubt a biopsy with evaluation by an experienced pathologist is recommended.
Once a melanoma has been found, a great deal of information can be obtained by a full assessment of the skin biopsy. At the Melanoma Program at Providence Saint John’s, our pathologists are very practiced in evaluating melanomas and provide all of the relevant information to help guide treatment decisions in a standard synoptic report. If the initial biopsy was done elsewhere, they are able to provide an expert review rapidly upon receipt of the biopsy slides.
Skin cancer can’t be diagnosed just by looking at it. If a mole or pigmented area of the skin changes or looks abnormal, a doctor may biopsy the mark, taking a tissue sample for a pathologist to examine. Suspicious areas should not simply be shaved off or destroyed with a hot instrument, an electrical current or a caustic substance. A biopsy should be performed first to determine if the area is malignant.
- Local excision/excisional biopsy
- The entire suspicious area is removed with a scalpel under local anesthetic. This is usually done as an outpatient procedure.
- Punch biopsy
- The doctor uses a tool to punch through the suspicious area and remove a round cylinder of tissue.
- Shave biopsy
- The doctor shaves off a piece of the growth and checked for any abnormal results.
Abnormal results may include: