Melanoma biopsy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

All patients with suspected melanoma require biopsy. Findings on biopsy may distinguish the sub-type and the stage of melanoma.

The following algorithm illustrates the approach to patients with suspected melanoma.^[1]

Suspicious pigmented lesion

Biopsy

Inadequate

Rebiopsy

Melanoma confirmed

Breslow thickness

Ulceration status

Mitotic rate

Depth and peripheral margin status

Presence of satellitosis

Clark level for lesions ≤ 1 mm

Reassessment with complete physical examination, including neurological exam and lymph node assessment

Patients who have lesions suspected to be melanoma should always be biopsied.^[1]
An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended.^[1]
Shave biopsy is acceptable only when the index of suspicion for melanoma is low.^[1]
The following should be reported when a biopsy is being reported:^[1]

To view the histopathologic characteristic features of all subtypes of melanoma, click here.

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). “Melanoma, version 2.2013: featured updates to the NCCN guidelines”. J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.