Diagnosing melanoma can be a difficult task, even for a trained dermatologist or physician. Because the symptoms are not always obvious, it is critical that you pay close attention to caring for your skin, and notify your doctor right away if you have concerns or find a suspicious mole – especially if you have a family history of melanoma.
If you or your doctor is concerned about a suspicious lesion, he or she may perform a biopsy.
Watch our YouTube video of Dr. Whitney High, MD, JD, MEng explaining all that goes into making a melanoma diagnosis.
Step 1: Biopsy/Tissue Analysis
There are several different types of biopsies. Most commonly, tissue is removed from the skin and examined under a microscope by a skin analysis specialist, often a dermatopathologist specializing in melanoma biopsies. After analyzing the tissue, the pathologist will issue a pathology report. The pathology report will include detailed scientific information on the biopsy and will help your doctor determine your treatment options.
The main types of skin biopsies are:
- Fine Needle Aspirate (FNA)
- Shave Biopsy
- Punch Biopsy
- Incisional Biopsy
- Excisional Biopsy
Step 2: Lymph Node Status
If the original or primary melanoma has certain high-risk characteristics, your doctor will want to examine your lymph nodes to determine whether any cells have traveled beyond the initial site.
To confirm whether cells have migrated, your doctor will perform a sentinel lymph node biopsy. If melanoma cells are found in the sentinel node, a second surgery to remove and examine additional lymph nodes should be performed. These additional lymph nodes are also evaluated by a pathologist to determine if they contain any melanoma cells. If no melanoma cells are found, then no further surgical intervention will be performed.
The extent of lymph node involvement, as well as several other factors, will help determine the stage of diagnosis. Your stage at diagnosis will determine the best treatment option(s), and ultimately, your prognosis.