If you have any signs or symptoms of skin cancer, see your doctor as soon as possible. Your doctor will thoroughly examine your skin and ask you about your general health, lifestyle, and family history. You may need to see a dermatologist (skin doctor), who will use a dermatoscope, a magnifying lens with a light, to look at the skin more closely. If your doctor suspects a spot may be skin cancer, he or she will perform a biopsy to be certain. A biopsy is best when there is any question of the diagnosis. Here are some procedures your doctor may recommend to diagnose skin cancer:
A biopsy is the only way to be certain a spot on your skin is cancer. Your doctor will take a tissue sample from a suspicious area of your skin and have it sent to a lab to be examined under a microscope. There are a few different types of skin biopsies your doctor may recommend.
Your surgeon uses a razor blade to shave off the outer layers of the skin to be examined under a microscope. A shave biopsy may miss the true extent of the depth of the lesion.
Your surgeon uses a special instrument to remove a cylinder of tissue from deeper layers of skin. A punch biopsy is good for determining the depth of the lesion.
Your surgeon uses a scalpel to make an incision and remove only a part of the suspected tumor for examination.
Your surgeon uses a scalpel to remove the entire lump or spot and a margin of surrounding tissue for examination.
Lymph Node Biopsy
Your doctor may perform a lymph node biopsy to find out whether the skin cancer has spread to your lymph nodes. Your doctor may perform a needle biopsy or a sentinel lymph node biopsy, a type of directed excisional biopsy:
Fine Needle Aspiration Biopsy
If you have an enlarged lymph node in the region of your skin cancer, your doctor might use a needle to sample that lymph node. This may or may not be performed with imaging guidance (Ultrasound or CT Scan). The pathologist will examine the sample under a microscope to look for signs of cancer.
If the needle biopsy is unsuccessful in providing a diagnostic sample, your doctor may remove an entire lymph node(s) and have it sent to a lab to be examined under a microscope. In rare cases of advanced Squamous Cell Carcinoma, your doctor may recommend a sentinel lymph node dissection using a blue dye and radiotracer to identify the node(s) most likely to have cancer cells, to see if the tumor has spread to the lymph nodes. The sentinel node(s) are removed and sent for pathological evaluation. If the sentinel node is negative, usually no further treatment to the lymph nodes is required. If the sentinel node is found to contain tumor cells, your doctor may recommend further treatment or closer follow-up of the remaining lymph nodes.