Diagnosis
If you have a change on the skin, the doctor must find out whether it is due to cancer or to some other cause. Your doctor removes all or part of the area that does not look normal. The sample goes to a lab. A pathologist checks the sample under a microscope. This is a biopsy. A biopsy is the only sure way to diagnose skin cancer.
You may have the biopsy in a doctor's office or as an outpatient in a clinic or hospital. Where it is done depends on the size and place of the abnormal area on your skin. You probably will have local anesthesia.
There are four common types of skin biopsies:
- Punch biopsy: The doctor uses a sharp, hollow tool to remove a circle of tissue from the abnormal area.
- Incisional biopsy: The doctor uses a scalpel to remove part of the growth.
- Excisional biopsy: The doctor uses a scalpel to remove the entire growth and some tissue around it.
- Shave biopsy: The doctor uses a thin, sharp blade to shave off the abnormal growth.
You may want to ask your doctor these questions before having a biopsy:
- Which type of biopsy do you recommend for me?
- How will the biopsy be done?
- Will I have to go to the hospital?
- How long will it take? Will I be awake? Will it hurt?
- Are there any risks? What are the chances of infection or bleeding after the biopsy?
- What will my scar look like?
- How soon will I know the results? Who will explain them to me?
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Staging If the biopsy shows that you have cancer, your doctor needs to know the extent (stage) of the disease. In very few cases, the doctor may check your lymph nodes to stage the cancer.
The stage is based on:
- The size of the growth
- How deeply it has grown beneath the top layer of skin
- Whether it has spread to nearby lymph nodes or to other parts of the body
These are the stages of skin cancer:
- Stage 0: The cancer involves only the top layer of skin. It is carcinoma in situ.
- Stage I: The growth is 2 centimeters wide (three-quarters of an inch) or smaller.
- Stage II: The growth is larger than 2 centimeters wide (three-quarters of an inch).
- Stage III: The cancer has spread below the skin to cartilage, muscle, bone, or to nearby lymph nodes. It has not spread to other places in the body.
- Stage IV: The cancer has spread to other places in the body.
