EVALUATION OF SUSPICIOUS SPOTS

When a spot is suspicious, your healthcare provider will often perform a skin biopsy to determine if the spot is cancerous. In this surgical procedure, a piece (or all) of the spot is cut out and is processed. A specialist will look at the processed material under the microscope to see if it looks like melanoma.

A pathologic examination of a biopsy sample is considered the gold standard for the diagnosis of melanoma; however:

A biopsy can be overused due to an abundance of caution. A biopsy is a procedure that is needed to make a diagnosis of melanoma, but most lesions that are biopsied due to concern that they could be melanoma will turn out to be benign (noncancerous).

Biopsies increase the risk of bleeding, scarring, and infection. Not all areas can be easily biopsied because of the way the skin lies or because of risk of bleeding (e.g., the scalp, side of the nose, or the shin).

Some people may want to avoid biopsies. If you have diabetes or a bleeding disorder, you may be concerned about complications. If you have anxiety about the cutting procedure, you may wish for an alternative.

Sometimes, biopsies can miss some melanomas or diagnose some noncancerous spots as melanomas. Why does this happen? First, a biopsy and pathologic examination often look at only a piece of the spot, so it’s possible that the part of the spot that contains the melanoma is not evaluated. Secondly, not all specialists reviewing the specimens agree on what is a melanoma and what is not. That’s one reason a second opinion can be helpful when you have your pathology read.