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Melanoma Diagnosis

Melanoma Diagnosis


If you have suspicious moles or spots, you should immediately contact your dermatologist or physician. The first step in determining the outcome, is to perform a biopsy if the doctor sees a cause for concern. A biopsy is when a tiny amount of tissue from the affected area is removed from the skin and sent to a lab to obtain results. Under a fine microscope, each skin specimen is examined to determine if the tissue contains melanoma.

There are several different skin biopsies depending on the size, type and location of your mole:

  • Shave biopsy - a lesion is severed using a scalpel by the physician. This most often happens in the office.

  • Punch biopsy - the removal of a small lesion or portion of a large lesion using a special device that obtains a full-thickness skin specimen.

  • Incisional biopsy - the lesion and affected areas are cut out of the skin, used when the lesion is larger.

  • Excisional biopsy - the affected area, lesion and surrounding tissue are removed to assure the melanoma is gone. Can be used on smaller or larger lesions.

  • Sentinel lymph node biopsy - a dye and radioactive tracer are injected into the affected area. Then, once these agents reach the lymph nodes, a small incision is made and the lymph nodes are removed. Using a microscope, pathologists will investigate the tissue and determine if any melanoma cells are detected. A second surgery may be needed if there is in fact melanoma.

  • Fine needle aspiration (FNA) - fluid and cells are removed from the tissue or tumor via a needle. It is then smeared on a slide to investigate with a microscope. This can be done in-office.


The pathology report containing the prognosis will then be supplied to your physician. The depth of the mole (referred to as the Breslow Thickness or Clark’s Level) and prognosis of ulceration are determined based on this report. The mitotic rate should also be measured; it is the frequency of division of the melanoma and cells. The faster the cells divide to become larger, the greater the chance of metastasis. If the tests prove the lesion to be a melanoma, a second and deeper biopsy will most likely be performed to ensure the complete removal of abnormal tissue and any affected, surrounding tissue.

Next, if the test is positive--you will have to determine which stage of melanoma you are experiencing as well as your lymph node status. If the melanoma you are diagnosed with has high risk characteristics (such as a depth beyond 1mm, ulceration, regression) a sentinel lymph node biopsy is usually performed.

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Melanoma Safety Guide

  1. What is Melanoma? How can it be prevented? 
  2. Causes of Melanoma--Risk Factors
  3. Facts about Melanoma
  4. Melanoma Detection
  5. Self-Check for Melanoma
  6. Find a Doctor for Melanoma
  7. Melanoma Diagnosis (You are here.)
  8. Treatment of Melanoma
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