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Most melanoma diagnoses begin with the patient, a loved one, or a doctor noticing a new, abnormal, or changing mole or lesion on the skin. As with many kinds of cancer, early detection and treatment is critical to preventing early stage melanoma from progressing to the more advanced stages. Knowing the ABCDEs of melanoma identification and performing regular self-checks and check‐ups are crucial steps in treatment and prevention. Before an official melanoma diagnosis can be made, however, your doctor will biopsy the lesion and send it to a pathologist who will look at it underneath a microscope to confirm the diagnosis.

Below is a list of the types of biopsies typically done on lesions suspicious for melanoma. 

  • Shave Biopsy: In a shave biopsy, a scalpel or blade is used to remove a thin layer of tissue off of the suspected site. A shave biopsy does not penetrate below the dermis, and results in minimal scarring.

  • Excisional Biopsy: In an excisional (or incisional) biopsy, a larger piece of tissue will be cut away. Compared to a punch biopsy, an excisional biopsy will likely be used when the suspected tumor is thicker or deeper in the tissue. In many cases, an excisional biopsy will be used to completely remove the suspicious area. If it is found to be cancerous, but no additional cancerous cells are found, treatment may be effectively complete after the biopsy.

  • Punch Biopsy: After applying a topical anesthetic the physician uses a small round tool to cut away the piece of skin being sent to biopsy. 

Once the suspected lesion is viewed under the microscope and confirmed to be cancerous, the doctor will proceed by staging the tumor. Cancer staging is the process of determining how much cancer is in the body and where it is located. Staging describes the severity of an individual's cancer based on the magnitude of the original (primary) tumor as well as on the extent cancer has spread in the body. Learn more about how melanoma is staged here.

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