Care / What to Expect when Diagnosed

If a melanoma is suspected, a skin biopsy is conducted.

This means that the doctor will take a sample of skin from the suspicious area for examination under a microscope.

There are different methods used to obtain the skin sample, depending on the size and location of the suspected area:

• Punch biopsy - a special tool that rotates and cuts through layers of the skin to take a small sample is used.
   
• Incisional biopsy - removes a deeper skin sample using a surgical knife to cut through the full thickness of the skin. Only a portion of the tumor is removed.
   
• Excisional biopsy - removes a deeper skin sample using a surgical knife to cut through the full thickness of the skin. The entire tumor is removed. This is the preferred method when a melanoma is suspected.
 

A portion of normal appearing skin around the suspicious area is also recommended for removal. This is referred to as the tumor margin and is done to ensure that no melanoma is left behind.

These biopsies each use a local anesthetic to numb the affected area. They are simple and quick procedures that can be performed in the doctor’s office.

The samples are examined by a pathologist under a microscope to confirm the presence or absence of melanoma. When a biopsy is performed and melanoma is detected the depth of invasion is measured. The deeper the melanoma the more likely it is to have spread to the surrounding and adjacent tissues.

The first place melanoma or any cancer will travel is to the lymph nodes that drain the area. Lymph nodes are part of the lymphatic system. This is a series of nodes and vessels throughout the body that are responsible for cleaning body fluids. Vessels drain to lymph nodes which act as filters capturing the cancerous cells. To determine if the local lymph nodes are involved, a fine needle aspiration biopsy will be recommended. This procedure utilizes a thin needle to remove a very small sample from a tumor. A CAT scan is sometimes used to guide the needle to the correct site.

An excellent resource for those newly diagnosed with melanoma patients is a booklet entitled: “I Have Melanoma, Now What.” Contact the Foundation if you would like to get a copy of this at contact@melanomaresource.org.

Miss Maryland 2006, Brittany Lietz launching the publication of the booklet “I Have Melanoma Now What?”