Basal and squamous cell carcinomas, along with other type of skin cancers that are less common, can often be diagnosed with biopsies. A biopsy involves taking a tissue sample that is sent to a lab to be examined for the presence of cancer cells.
When a Biopsy is Recommended
Skin cancer is diagnosed in one of three ways: a biopsy, dermoscopy and mole mapping. Dermatologists often recommend biopsies for patients who have suspicious moles or other skin growths that are cause for concern. Patients may have noticed bleeding, oozing and scab formations in these problematic areas. Skin spots that have irregular borders or have changed in size, shape or color could also be showing symptoms of skin cancer that should be further investigated through biopsy.
Before the Biopsy
Prior to a biopsy being performed, a dermatologist will take note of a patient’s medical history and conduct a physical examination to determine if further testing is needed. A physical examination can also be performed by a primary care physician who may refer a patient to a dermatologist if a biopsy is recommended. A special magnifying lens known as a dermatoscope is sometimes used to look for cancer cells in suspicious places on the skin during a physical examination. Surrounding lymph nodes can also be felt for any swelling. Board-certified dermatologist Dr. Tony Nakhla may not recommend a biopsy if the initial findings don’t warrant any concerns.
The Biopsy Process
Skin biopsies can be performed by a board-certified dermatologist on an out-patient basis. Local anesthetic is usually used to numb the area so that the patient doesn’t experience any pain during or immediately after the biopsy. Some bleeding and minor scarring should be expected after the tissue sample is removed.
The type of biopsy performed will depend on the size and location of the suspicious skin spot. Some of the most common types of biopsies that are used to diagnose skin cancer include:
- Incisional and Excisional Biopsies – In an incisional biopsy, only part of the area in question is cut from the skin to be examined. An excisional biopsy is usually needed to look at deeper skin layer levels and can often remove an entire tumor with a surgical knife.
- Shave Biopsy – Also known as a tangential biopsy, this involves the use of a small surgical blade to shave off the top skin layers that will be examined under microscope. Ointment or cauterization may be used to stop the bleeding from the area where the tissue was removed.
- Punch Biopsy – A handheld instrument that resembles a cookie cutter is used in this type of biopsy when deeper skin layers need to be removed. Rotational movements are made with the instrument to remove enough tissue. Stitches are sometimes applied to the biopsy site to close the wound.
- Fine Needle Aspiration Biopsy – In rare instances when squamous or basal cell carcinoma has thought to have spread from the skin to a nearby lymph node, fine needle aspiration can be a helpful diagnostic tool. Small fragments of lymph node are drawn out through a fine needle that causes minimal discomfort and no scarring.
- Surgical Lymph Node Biopsy – This type of biopsy is sometimes recommended when a fine needle aspiration biopsy doesn’t find any cancer cells but the doctor still believes that cancer has spread to a lymph node. A surgical procedure that can often be performed on an out-patient basis in a dermatologist’s office can remove a lymph node directly beneath the skin for examination.
Anyone who believes that a suspicious area of skin may be cancer can see a leading skin cancer surgeon in Orange County at the OC Skin Institute for an examination. Contact us today for a consultation if you are concerned about a potential skin cancer diagnosis or are actively pursuing treatment.