Any persistent changes to the skin should be brought to a doctor's attention. They will then conduct a physical exam of the suspected area of tissue. To get a definitive diagnosis, this suspicious tissue must be examined under a microscope. The process of retrieving this tissue is known as a biopsy.
There are different types of biopsies to diagnose skin cancer. Doctors recommend the specific procedure based on the size, shape, and location of the growth. Patients typically are given a local anesthetic before the procedure and may receive stitches afterward to close the wound.
Types of skin cancer biopsies
Local excision/excisional biopsy: All or part of the suspicious area is removed with a scalpel under local anesthetic. Depending on the size and location of the area, this type of biopsy may be done in a doctor's office or as an outpatient procedure at a hospital. If the growth is small enough to be removed entirely during the biopsy, local excision can be both a diagnostic procedure and a treatment.
Punch biopsy: The doctor uses a special tool to punch through the suspicious area and remove a round cylinder of tissue. If needed, patients may receive stitches to close the wound.
Shave biopsy: The doctor shaves off a piece of the growth. This can be performed with a scalpel, surgical scissors or other special tools. Typically, no stitches are needed.
After the biopsy procedure, the skin sample is sent to a pathologist, a doctor who specializes in diagnosing disease. After examining the tissue under a microscope, the pathologist will make a diagnosis.
Abnormal results include benign (non-cancerous) growths such as moles, warts, and benign skin tumors. If the sample reveals cancer, the pathologist will determine if it is a basal cell carcinoma, squamous cell carcinoma, or melanoma.
Determining if your cancer has spread
Basal cell cancer usually remains in one location and does not spread. However, especially for melanoma or squamous cell cancer that encompasses large areas of skin, additional tests may be needed to see if cancer has spread (metastasized). Skin cancer may invade other layers of skin or travel to surrounding nerves or lymph nodes. Patients may undergo some medical imagining or have their lymph nodes biopsied if the doctor suspects that cancer has spread.
Getting a skin cancer second opinion at MD Anderson
The pathologists at MD Anderson are highly specialized in diagnosing common and rare skin cancers. We welcome the opportunity to provide second opinions for skin cancer.
Some people have an elevated risk of developing skin cancer. Review the skin cancer screening guidelines to see if you need to be tested.
Behavioral and lifestyle changes can help prevent skin cancer. Visit our prevention and screening section to learn how to manage your risk.
In rare cases, skin cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
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