What is biopsy?

Early detection of skin cancer is critical if it is to be properly treated.

If you have a suspicious or unusual mole or growth your doctor may want to obtain a sample of the skin for diagnosis, this procedure is called a biopsy.

A biopsy helps your doctor tell the difference between a benign, non-cancerous growth and a skin cancer.

Performing a biopsy can help your doctor to be sure about the correct diagnosis of the growth, mark or lump on your skin.

The biopsy procedure is performed in the doctor’s office and usually no preparation is required on your part.

What is the process?

Before the biopsy is performed you will be given a small injection of local anaesthetic to numb the area. This may sting briefly, but the anaesthetic usually takes effect very quickly, and the rest of the procedure is painless.

Depending on the type and size of the mole or growth, one of the following forms of skin biopsy may be performed:

Excisional Biopsy: The entire mole or growth is removed in this procedure (excised), along with a small surrounding margin of normal skin. This method is usually performed when a mole or growth could possibly be a melanoma.

Shave Biopsy: A shave biopsy is usually performed when the lesion is thought to affect the top layer of the skin only or if the lesion is very large. A slice of skin is taken from the affected area using a scalpel or biopsy cutter. Stitches are usually not required for this procedure. However, a small scab will form, which will heal within a week or so.

Punch Biopsy: A punch biopsy is used to diagnose many less serious skin cancers.

This is a quick, convenient procedure, which generally produces only a small wound. Punch biopsies provide a sample of cells from the full thickness of the skin.

An instrument called a punch biopsy cutter is used in the procedure. This is a straw-like instrument with a sharp end, which works like a cookie-cutter.

The punch biopsy cutter is pushed through the skin and twisted, producing a cylindrical sample of skin, which is then cut from its base with scissors or a scalpel.

Band-aids, steri-strips or stitches may be used to close the incision. Stitches are generally not required for punch biopsies unless bleeding is slow to stop or the biopsy has to be large.

Incisional Biopsy: If you have a larger mole or growth your doctor may perform an elliptical incisional biopsy.

The end sample yielded by this procedure is bigger than that of a punch biopsy.

The doctor will use a scalpel to cut an elliptical sample from the area. Stitches may be required with this procedure and a fine-line scar may remain.

Any band-aids or steri-strips can be removed after a day or so and the wound should then be cleaned with antiseptic.

Once it has been cleaned, the wound can be left open to form a crust, which usually falls off in a few days to a week.

If you experience any delayed bleeding, or your work requires heavy or dirty duties, you should keep the wound covered.

If stitches were used to close the incision, you will be asked to make an appointment with your doctor about a week after your biopsy for them to be removed.

What happens to the sample?

The biopsy sample is sent to a laboratory where a Pathologist examines it under a microscope.

The pathologist will determine whether the mole or growth is benign (harmless) or malignant (a skin cancer). The result will take about a week to get back to your doctor.

So what happens next?

There are three possibilities: the biopsy may show something which requires no treatment at all; the biopsy may show something which is not a skin cancer but which needs to be treated (often a sun-spot, which needs to be frozen); or the biopsy may show a skin cancer, which always needs to be treated.

Your doctor will discuss the treatment options with you.

If the biopsy shows a skin cancer, the treatment recommended by your doctor will depend on the type and stage of the cancer, the size and place of the growth and also your medical history and general health status. In the majority of cases, the treatment will be to remove or destroy the cancer entirely.

You and your doctor can work together to tailor a treatment plan that suits your needs best.

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