What Are the Different Types of Skin Biopsies?

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Skin cancer lesions come in many different shapes, sizes, colors and textures. Sometimes, a malignant growth can look like a mole. At other times, a benign skin growth can look suspiciously like cancer. When a potential skin tumor is detected, the only way to make a really accurate diagnosis is by performing a skin biopsy. The procedure can be performed at a dermatologist’s office. Then, the sample tissue is sent to a trained pathologist to be examined for signs of abnormal cell structure. If the biopsy catches a tumor while it is still in the early stages of formation, the cure rate is extremely high – around 95%.

There are several types of initial biopsy that can be used on a skin lesion. A dermatologist decides which technique to use based on the size/location of the tumor and what type of cancer it is most likely to be.

Cutting Out the Whole Thing

Sometimes, a suspected tumor is small enough that simply removing the affected area makes more sense than performing multiple procedures. With an excisional skin biopsy, the dermatologist cuts out the lesion and a small surrounding area of seemingly healthy skin. This helps ensure that the entire tumor has been removed and that there are no abnormal cells left beyond the visible margins of the tumor. If the results come back showing that melanoma is present, further investigation may still be needed to ensure the cancer has not spread. If it is a non-melanoma cancer, the entire removal of the tumor is usually sufficient treatment.

Taking Just a Small Piece

An incisional biopsy is used for large lesions where removing the whole suspected tumor might leave a disfiguring scar or require reconstructive surgery. In these situations, the biopsy is done first to confirm whether there is actually a reason to move forward with a full scale skin surgery. A scalpel or razor can be used to shave off a small piece of the tumor. Or, a punch (a hollow tube with a sharp edge) can be used to extract a small cylindrical sample.

For a tumor located in the upper to mid-layers of the skin, the biopsy methods listed above are not highly invasive. A skin biopsy is done under local anesthesia which makes the procedure itself close to pain-free. Post-procedure pain is usually minimal and easily managed. Even if it turns out that the suspected tumor is benign, the patient is only left with a small scar.

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