NCCN Guidelines for Patients® | Melanoma - page 19

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
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Tests for melanoma
Tumor tissue tests
Physical and skin exam
Doctors usually perform a physical exam along with
taking a medical history. A physical exam is a review
of your body for signs of disease. Your doctor will also
perform a medical skin exam. For this, your doctor
will carefully inspect your skin for lesions and areas
that look abnormal (not normal). A lesion is an area of
abnormal tissue that has been damaged by disease
or injury. Your doctor will note the size, shape, color,
and texture of any lesions. Your doctor will also feel for
enlarged lymph nodes in the area where the melanoma
lesion is or was located. Unusual symptoms, such as
bleeding or scaling, may be other signs of cancer. Be
sure to have skin exams on a regular basis.
Besides your skin, other parts of your body may be
examined to look for signs of cancer. During this
exam, your doctor may listen to your lungs, heart,
and intestines. Parts of your body, such as your liver
or spleen, may be felt to see if organs are of normal
size, are soft of hard, or cause pain when touched.
Tumor tissue tests
To confirm if you have melanoma, a sample of tissue
must be removed from the concerning spot on your
skin to test for cancer cells with a microscope. This is
called a biopsy. Based on the physical and skin exam,
your doctor may perform a skin biopsy. There are
many types of skin biopsies used for melanoma. The
type of biopsy you will have depends on the size and
location of the concerning spot (lesion) on your skin.
Types of skin biopsies
Excisional biopsy
An excisional biopsy removes the entire lesion and a
small amount of normal-looking skin around the edge
using a surgical knife.
Incisional biopsy
An incisional biopsy removes only part of the lesion
with a surgical knife. This biopsy may be done for
a very large lesion. It may also be used for a lesion
that’s in a place where it can’t be easily removed such
as the face, ear, palm of the hand, or sole of the foot.
Punch biopsy
A punch biopsy uses a sharp hollow device—like a
cookie cutter—to remove a small but deep sample of
both skin layers.
See Figure 7.
This kind of biopsy
may be better for very large lesions or certain areas
of the body. These areas include the face, ear, finger,
toe, palm of the hand, or sole of the foot.
Figure 7. Punch biopsy
A punch biopsy uses a
sharp hollow device—like
a cookie cutter—to remove
a small but deep sample of
both skin layers.
Illustration Copyright © 2014 Nucleus Medical Media, All rights reserved.
Area to be
removed
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