NCCN Guidelines for Patients® | Melanoma - page 20

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
18
2
Tests for melanoma
Tumor tissue tests
Shave biopsy
A shave biopsy removes the epidermis and the top
part of the dermis. The epidermis is the outer layer
of skin. The dermis is the second layer of skin, under
the epidermis. A shave biopsy is usually not done if
your doctor thinks the melanoma has grown into the
dermis. This is because it wouldn’t tell how deep the
cancer has grown. A shave biopsy is often used to
remove moles that look normal and for skin diseases
other than melanoma.
What to expect during a skin biopsy
Before a biopsy, your doctor will numb your skin with
local anesthesia. Local anesthesia is a controlled loss
of feeling in a small area of the body due to drugs
being given in that area. Tell your doctor if you’ve had
any reactions to anesthesia in the past. With local
anesthesia, you’ll feel a small needle stick and a little
burning with some pressure for less than a minute.
Then, there will be a loss of feeling in that area for a
short time. You may feel a little pressure during the
biopsy, but no pain. After the biopsy, your doctor may
close the wound and apply a bandage. There are
usually no side effects, but scars can form after some
biopsies. If you are on blood thinners, adjustments
may be needed before a biopsy can be done.
At the lab
Your doctor will send the biopsy tissue sample to a
lab so a pathologist can examine it with a microscope
for cancer cells. A pathologist is a doctor who’s an
expert in testing cells and tissues for disease. If
the pathologist finds melanoma cells, he or she will
determine if the cells are growing into the dermis
and measure how deeply they are growing. The
pathologist will also assess other features of the
melanoma and describe them in the pathology report
(see page 19). The pathologist may perform different
tests on the skin biopsy samples if first test results
aren’t clear.
If the pathologist finds cancer cells in the biopsy
sample, your doctor may order more tests. Depending
on the extent of the melanoma, other tests may be
done to see if it has spread. Cancer that has spread
from the first tumor to other sites in the body is called
a metastasis. Metastases are more likely if the skin
tumor has grown deep into the dermis—the second
layer of skin. The next section describes the possible
tests that may be used to check for metastases.
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