Diagnosing Skin Cancer

Skin cancer is typically detected with a physical examination of the body. However, unless a biopsy is performed to remove and test the suspicious skin, your doctor won’t know for sure if it’s cancerous or not. A biopsy is the only sure way to diagnose skin cancer and the type of skin cancer.

Where your biopsy takes place depends on the size and place of the abnormal area of your skin. For some, a skin cancer biopsy may be done in a dermatologist’s office. For others, it may be done as an outpatient procedure in a clinic or hospital. Regardless of where you have your biopsy done, it will probably involve local anesthesia. You don’t typically need to be put “under” for this type of procedure.

There are four common types of skin biopsies:

  • Shave Biopsy: The doctor uses a thin, sharp blade (similar to a razor) to shave off the abnormal growth from the top layers of skin (epidermis and a portion of the dermis).
  • Punch Biopsy: The doctor uses a circular tool to remove a small section of tissue from the abnormal area including, deeper layers (epidermis, dermis and superficial fat).
  • Incisional Biopsy: The doctor uses a scalpel to remove only part of the growth.
  • Excisional Biopsy: The doctor uses a scalpel to remove the entire growth and some tissue around it, including a portion of normal skin down to or through the fatty layer of skin.

If the doctor suspects that the skin cancer is melanoma, a shave biopsy is not typically used. For melanoma, an excisional biopsy is typically performed, or, if the growth is too large to be removed entirely, a tissue sample will be taken.