Melanoma Treatment - Surgery
Surgery is the mainstay of therapy for early-stage melanoma and for the removal, or resection, of a diagnosed melanoma. Skin biopsy techniques and sentinel lymph node biopsies are first-line surgical procedures used in diagnosing melanoma; once diagnosed, many other types of surgery are employed when appropriate.
Types of Surgery
The initial biopsy may be performed by a dermatologist or dermatologic surgeon. Surgery to remove melanoma may be performed by a surgical oncologist, a plastic surgeon, a head-and-neck surgeon or by a combination of these specialists, using the following techniques:
- Simple Excision: thin melanomas are removed along with a small amount of non-cancerous skin at the edges.
- Mohs Surgery: a small section of apparently normal skin beyond the visible melanoma is removed and looked at under a microscope. If abnormal cells are identified, another small section is removed and this process continues until the cells removed no longer look abnormal.
- Wide Local Excision: this excision is used to decrease the chance of local recurrence. A wide excision, usually 1-2 cm, is made around the original melanoma site, and the tissue is sent to the pathologist for evaluation.
- Sentinel Lymph Node Biopsy: a radioactive tracer and dye are injected into the site of the primary melanoma to “drain” the lymph node basin. They are then examined under a microscope to determine if there are any melanoma cells detected.