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Skin Cancer Melanoma Biopsy and Histology

Biopsy and histology

Biopsy all suspicious lesions. Palpate the regional nodes prior to biopsy and document the findings. The only “perfect” biopsy technique is complete excision of the entire lesion into subcutaneous fat. This allows for accurate measurement of the thickness of the lesion in millimeters referred to as the Breslow depth of invasion.

Biopsy and histologic review distinguish melanoma from other tumors. All nevi which are removed for diagnostic or cosmetic purposes should be submitted for histologic review. Incomplete excision or biopsy of nevi can lead to recurrence with epidermal hyperplasia of atypical appearing melanocytes. This recurrent nevus phenomenon can be clinically and histologically indistinguishable from superficial spreading melanoma. The original excision or biopsy must be available for review to exclude a diagnosis of melanoma.