The best intervention for skin cancer (and other skin-related diseases) is early detection and treatment, when the cancer is small and localized. A biopsy of skin is the first step with a suspected skin cancer and many other skin lesions. Identification of the type of skin tumor or lesion is crucial for proper treatment and is most accurately performed by a dermatopathologist, a pathologist who has specialized training in skin disease and tumor identification.
How are skin biopsies performed?
If your doctor recommends that a sample of your skin be removed, this sample, or biopsy, may be sent to a laboratory. There are several different methods which may be used to obtain a skin specimen. Choice of technique is determined by several factors, including the location, size, and type of lesion to be biopsied. All methods should include local injection or topical application of an anesthetic.
Shave biopsy: After administering local anesthetic, the superficial layers of skin are shaved off.
Punch biopsy: After administering local anesthetic, a small cylinder of skin is removed with a sharp, hollow instrument.
Excisional biopsy: A local anesthetic is injected and the entire clinical lesion is removed (lump, spot, or sore), going as deep as necessary to get the entire area. The incision is the closed with stitches.
How are skin biopsies examined?
Skin biopsies are processed into microscopic slides and then stained with Hematoxylin and Eosin (H&E), a routine histology stain to allow the the dermatopathologist to visualize the cellular details of the biopsied tissue. The dermatopathologist can then systematically examine the biopsy at a microscopic level. Based on the findings, the dermatopathologist may come up with a definitive diagnosis, or list several possible explanations, creating a differential diagnosis. The integration of clinical information in conjunction with the pathological findings generates the final diagnosis.
In some cases, special studies on the tissue may be required to fully evaluate and diagnose your condition. The results of any of these studies are available to your physician and to you. The microscopic slides and diagnostic reports are stored in the laboratory should you or your physician request additional reports, review, consultation, or second opinion.
If you have a condition that requires surgical excision, the tissue removed will be submitted for analysis just as is a biopsy.
When will I receive my test results?
At KDL, every specimen is important. Depending on the test performed, most tests are completed and reported to the ordering physician within 24 hours of receiving the specimen into the laboratory. Certain tests may take longer. Results are sent directly to the physician, who will contact you when your pathology report has been received.
The fee for biopsy service includes transportation of the sample to the laboratory, external examination of the sample, processing of the sample into a microscopic slide, review of the slide by a dermatopathologist, and reporting results to your doctor.