After your initial consultation, if Dr Perrett or one of his colleagues thinks that a mole, lump or other problem area of skin may be cancerous, they will undertake a skin biopsy to investigate further.
What is a skin biopsy?
A biopsy involves removing some of the skin cells for examination under a microscope. The removal of the skin is performed under local anaesthetic and usually only takes a few minutes. The skin sample is then examined under the microscope to check for the presence of cancer cells, and if they are present, what type of skin cancer has developed.
Having a skin biopsy does not automatically mean you have skin cancer, as skin biopsies are often taken as a precaution to rule out cancer. Your result may come back clear and the cause of your skin problem will be investigated further.
Why have a skin biopsy?
Skin cancer is best identified as early as possible, before it spreads into the lymphatic system and/or other organs of the body. Having a skin biopsy allows your dermatologist to determine the type of skin cancer you have and the likelihood of the cancer spreading.
Skin biopsies can also be used following cancer surgery or other treatment, such as radiotherapy or chemotherapy, to determine whether the cancer has been fully removed or cured, or whether further treatment is required.
Skin biopsies are done under local anaesthetic and will sometimes leave a small scar. Punch and incision/excision biopsies will usually need stitches to help them heal. In some cases, especially with excision biopsies, the test doubles as the treatment, as the whole of the tumour is removed leaving a healthy margin of cancer free cells.
Types of skin biopsy
At The Devonshire Clinic we offer several different types of skin biopsy, and the type that is used will depend on the type and depth of the suspected cancer.
The four main skin biopsy techniques are:
- Shave biopsy. This is a limited technique that shaves a shallow sample of the epidermis and the upper dermis. It is only used when there is a low risk of melanoma, or in cases where the cancer is not thought to have penetrated too deeply into the skin cells. Shave biopsies leave a surface wound that will often heal without scarring.
- Punch biopsy. A small, round punch tool is used to cut a cylindrical sample of the skin including the epidermis, dermis and upper subcutis (the layer of connective tissue just beneath the dermis). A punch biopsy will often require stitching to help it heal and may leave a small scar.
- Incision biopsy. This involves the surgical removal of a sample of the suspected cancer using a scalpel. The incision will usually require stitching to help it to heal.
- Excision biopsy. Similar to an incision biopsy, except that in this case, the surgeon aims to remove the whole of the suspected tumour rather than just taking a sample. Not only will the cancer itself be analysed under a microscope, but the edges of the sample will also be checked to ensure that a healthy margin of cancer free cells has been left at the excision site. While excision biopsies will usually leave a larger scar, they do have the benefit of being both test and treatment in one procedure.
The results of a skin biopsy
You will usually get the results of your skin biopsy quickly. Our dermatologists will explain whether or not the problem was cancerous, what type of cancer is present, and what treatment, if any, is required.