Detecting & Diagnosing Melanoma

Melanomas can develop anywhere on your body. Because of this, we recommend that men and women of all ages should get to know every square inch of their skin. The more familiar you become with your moles, freckles, and birthmarks, the more likely you’ll be able to identify changes or new growths. So any melanomas can be treated quickly and successfully.

Detecting Melanoma

Melanoma can often be found early when it’s easiest to be cured. Detection starts with self-exams and exams by a healthcare professional.

Skin Self-Exam

Becoming familiar with your skin involves performing monthly self-exams to inspect your skin for any signs of skin cancer. It’s best to keep a record of your findings on a body map, which is a diagram of the body where you make marks that correspond to the marks on your skin. On the body map, you will make these marks, and then make a record of the mark’s color, size, shape, and the date found. Use the same map each month so that you are able to track any changes in existing spots and easily identify new spots.

You can download our version of a skin cancer body map to get you started!

With each self-exam, you’ll become more familiar with what is normal for your skin. Any new spots on the skin, along with any that change in size, shape, or color, should be seen by a doctor promptly.

Know Your Skin Cancer ABCDEs

If you are prone to freckles or moles, you may find it harder to determine which spots are normal and which ones require further evaluation. There are common signs that can help you determine if your spot is troublesome.

These are commonly referred to as the ABCDE Rule and include:

  • A for Asymmetry: Half of the mole or birthmark doesn’t match the other half.
  • B for Border: Irregular, jagged, blurry, or notched edges.
  • C for Color: Non-uniform color that includes different shades of black or brown or red, white, pink, or blue patches.
  • D for Diameter: The growth is more than ¼ inch in diameter (about the size of a pencil eraser.)
  • E for Evolving: The mole is growing or changing color or shape.

You can view examples of skin cancer and melanoma images on our webpage, Signs & Symptoms of Melanoma.

Not all skin cancers follow these rules, but many do. When in doubt about any mark on your skin that seems unusual, be cautious, and have it looked at by a healthcare professional.

Exam by a Healthcare Professional

Sometimes, doctors and other healthcare professionals will perform a skin exam as part of a routine health check-up.

If your primary doctor finds any irregular moles or suspicious areas, he or she may refer you to a dermatologist. Dermatologists can also do regular skin exams.

Diagnosing Melanoma

If your doctor finds an abnormal spot on your skin, he or she will usually examine it and perform tests. These tests are used to confirm if melanoma, another type of skin cancer, or some other skin condition is present. If melanoma is found, additional tests may be done to determine if it has spread to other areas of the body.

Physical Exam and Health History

During a physical exam, your doctor will discuss your symptoms in detail to get a better idea about your situation. You may also be asked about your possible risk factors for melanoma skin cancer. Risk factors such as your history of tanning and sunburns, and if you or anyone in your family has had a melanoma or other skin cancers are important to disclose to your doctor.

Your doctor will note the shape, color, size, and texture of any area(s) that are suspect, and whether it is bleeding, oozing, or crusting. He or she may also check the rest of your body for moles and other spots that could be related to different types of skin cancer or another type of skin condition.

Melanoma often goes to nearby lymph nodes first when it spreads. Therefore, it is also likely that your doctor will check the lymph nodes around the neck, underarms, or groin-area near the abnormal skin.

Skin Biopsy

If the doctor suspects melanoma, a biopsy will be needed. It is the only way to make a definite diagnosis. A biopsy can usually be done in the office using local anesthesia. A pathologist examines the biopsied tissue to check for the presence of cancer cells.

If the growth is too large to be removed entirely, the doctor removes a sample of the tissue. The doctor will never shave off or cauterize a growth that might be melanoma.

Types of Skin Biopsies

There are several different types of biopsies that may be performed. The four common types of biopsies include:

  • Punch biopsy. A procedure in which a small round piece of tissue about the size of a pencil eraser is removed using a sharp, hollow, circular instrument.
  • Excisional biopsy. In this procedure, the doctor tries to remove all of the suspicious-looking growth.
  • Incisional biopsy. This procedure removes only a portion of the tumor. It isn’t used as often as an excisional biopsy.
  • Optical or reflectance confocal microscopy (RCM). A newer type of biopsy which allows the doctor to look at an abnormal area to a certain depth without removing skin samples.

If you receive a diagnosis of melanoma, the next step is to determine the extent (stage) of the cancer. Once your doctor knows the melanoma stage, your treatment team can develop an appropriate plan specifically for you.