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How Is Melanoma Diagnosed?

If your physician suspects that a mark on the skin is melanoma, you will need to have a biopsy to make a definite diagnosis. A biopsy usually can be done in the physician’s office using local anesthesia. A pathologist then examines the tissue under a microscope to look for cancer cells.

If cancer is detected
If cancer is found, it then will be classified by a stage. The treatment of melanoma depends on the stage at which it is diagnosed. There are several important factors that determine the stage:

  • Breslow Thickness: The thickness of the melanoma, measured by the pathologist in millimeters. In general, thin melanomas (less than 1 mm thickness) have an excellent prognosis. Melanomas greater than 4 mm are serious melanomas with a significant chance of spreading to other parts of the body. Melanomas between 1 and 4 mm are called “intermediate thickness” melanomas, with an intermediate chance of spreading to other areas.
  • Clark’s Level: This is a measure of the level of invasion of the melanoma into the skin, graded from I to V. In general, it is not as helpful or accurate as the Breslow thickness. Many patients focus on the Clark’s level of invasion because it is a number they can easily remember. Many Clark’s level IV melanomas, however, have a very good outcome.
  • Lymph Nodes Status: Whether or not the cancer has spread to the regional lymph nodes (usually in the neck, under the arm or in the groin) is the single most important factor predicting survival.
  • Ulceration: Ulceration is defined by the pathologist as the absence of an intact epithelium overlying the melanoma. The epithelium refers to the cells that line the internal and external surfaces of the body. If ulceration is present, it indicates a worse prognosis.

To learn about each stage, including treatment options by stage, visit AboutMelanoma.com.

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