How Is Non-Melanoma Skin Cancer Diagnosed?

History and Physical Exam

Diagnosis of any medical condition begins with a medical history and physical exam. These procedures form the “framework” of your overall health.

From this general information, your doctor will begin to fill in the details, focusing on the symptoms that have brought you to seek medical care. You will be asked about your risk factors for skin cancer, such as sun exposure and whether you have had any type of skin cancer in the past; what symptoms you have noticed; and any other health problems or concerns. In addition to the medical history, a physical exam will be performed.

This typically includes measuring blood pressure and temperature. Any suspicious areas or patches of skin will be closely examined. Areas of your body that are not usually visible, such as the inside of your mouth and between your toes and fingers, will be examined for suspicious-looking lesions.

Biopsy

To make the diagnosis, your doctor will perform a biopsy of the area or lesion that is under suspicion. In this procedure, a small sample of tissue is collected and examined under a microscope to look for cancer cells. There are several types of biopsy that can be done to detect skin cancer. The type of biopsy that is performed will depend on the size and type of the growth. The entire growth may be removed, or only a part. All of these procedures are performed after the area has been numbed with a local anesthetic.

• Shave biopsy - A small blade is used to scrape off an abnormal growth.
• Punch biopsy - A small tool resembling a tiny cookie cutter is used to remove a small circular area of skin.
• Incisional biopsy - A scalpel is used to remove part of the abnormal area.
• Excisional biopsy - A scalpel is used to remove the entire abnormal area along with some of the surrounding, normal-looking tissue.
   
  All of these are minor procedures that can be done in the doctor’s office and rarely require a hospital stay.

Depending on which type of biopsy is done, you may have scarring afterward. In some cases, when a larger area of skin needs to be removed, a few stitches may be needed to close the incision. Less often, when very large areas are removed, a skin graft may need to be performed. In this procedure, healthy skin from elsewhere on the body (such as the inside of the thigh) is collected and used to cover the area where the surgery was performed.

This content has been reviewed and approved by Myo Thant, MD.