If melanoma is suspected, the doctor will take a sample of skin for examination. There are different methods used to obtain the skin sample, depending on the size and location of the suspected area. All biopsies are performed using a local anesthetic


Punch Biopsy – The doctor uses a special tool that rotates and cuts through layers of the skin to take a small sample.

Incisional and Excisional Biopsies – These biopsies remove a deeper skin sample, using a surgical knife to cut through the full thickness of skin. Incisional biopsies remove only a portion of the tumor. Excisional biopsies remove the entire tumor and are usually preferred when melanoma is suspected.

Fine Needle Aspiration Biopsy – Fine Needle Aspiration (FNA) biopsies use a thin needle to remove a very small tissue sample from a tumor. This test is not used on a suspected melanoma, but on a large lymph node near a melanoma to find if the melanoma has spread (metastasized). A CAT scan is sometimes used to guide the needle into a tumor in an internal organ when the doctor suspects that melanoma has spread to that organ.

Sentinel Lymph Node Biopsy – This a procedure that helps find out if cancer has spread by locating which lymph node or nodes are draining the tumor area. These nodes are then removed and examined under a microscope to see if they have trapped any melanoma cells. The presence of melanoma cells in the lookout “sentinel” lymph node automatically classifies a melanoma as stage III.

Microscopic Examination – Skin tissue samples are sent to a pathologist for examination under a microscope. The results of these confirm the presence or absence of melanoma.

(click on image for larger image)

Information provided by Chiron