Diagnosis/staging of melanoma

If you have noticed a changing molepigmented area or something abnormal?  Our providers at High Valley Dermatology are well experienced in diagnosis, treatment, and aftercare of Melanoma.    The following tests and procedures will diagnose melanoma:

  • A skin cancer screening or skin exam by your dermatologist: Early Detection is key.  Our dermatologists offer full skin checks and do free skin cancer screenings in the community through out the year.
  • Biopsy: removal of the abnormal tissue and a small amount of the normal tissue around it. The biopsy specimen is sent to a pathologist to check for cancer cells.

If the pathology comes back as melanoma, further tests are done to find out if the cancer has spread within the skin or further into the body, called staging. The stage of the cancer will determine treatment.

Staging is based mainly on the thickness of the tumor and whether the melanoma has spread to the lymph nodes and/or other parts of the body. It is based on the following:

  • The thickness using the Breslow scale
  • If the tumor is ulcerated (an open sore)
  • If the tumor has spread to the lymph system
  • If the tumor has spread to other parts of the body.

Melanoma spreads three different ways:

  • Into the normal tissue
  • Through the lymph system
  • Through the blood

The process of cancer cells spreading from the original or primary tumor to other places in the body where another secondary tumor may form is called metastasis. The new tumor is the same cancer as the primary tumor.

The staging goes as follows:

  • Stage 0 (Melanoma in Situ): there are abnormal melanocytes in the epidermis, the outermost layer of skin.
  • Stage 0: The abnormal melanocytes are found in the epidermis but may spread to the nearby normal tissue (also called in situ).

Stage I: cancer has formed, stage I is divided into two stages, IA & IB.

  • Stage IA: no more than 1 mm thick and no ulceration
  • Stage IB: one of two situations:
    • no more than 1 mm thick but has ulceration
    • or more than 1 mm but not more than 2 mm and no ulceration.
    • Thickness is considered differently depending on the location of the tumor.

Stage II is divided into three stages IIA, IIB, and IIC.

  • Stage IIA: In stage IIA, one of two situations:
    • more than 1 but not more than 2 mm thick, with ulceration
    • more than 2 but not more than 4 mm thick, with no ulceration.
  • Stage IIB: In stage IIB, one of two situations:
    • more than 2 but not more than 4 mm thick, with ulceration
    • more than 4 mm thick, with no ulceration.
  • Stage IIC: In stage IIC, the tumor is more than 4 mm thick, with ulceration.

In stage III, thickness can vary, with or without ulceration. However, one or more of the following will be true:

  • Cancer spread to one or more lymph nodes.
  • Lymph nodes could be joined together (matted).
  • Cancer may be found in a lymph vessel between the primary tumor and the nearby lymph nodes.
  • Very small tumors may be found on or under the skin, not more than 2 cm away from where the cancer first started.

In stage IV melanoma: The tumor has spread to other places, such as the liver, lungs, brain, bone, soft tissue or GI tract, spreading to places far away from where it started.

Recurrent melanoma: After melanoma has been treated and the cancer comes back. The cancer could come back where it was primarily or somewhere else in the body.

There several tests or procedures that could be done to determine the stage such as:

  • Lymph node mapping & sentinel lymph node biopsy
  • CT scan
  • PET scan
  • Blood chemistry

If you or a family member has the diagnosis of Malignant Melanoma we are here for you.   Call 522-SKIN (7546) to schedule an appointment.

“That beard is amazing!”

-jealous patients and coworkers

“I’ve been dealing with this for seven years and you were the one the figured it out.”

-satisfied patient

“I won’t go anywhere else!”

-satisfied patient

“Thank you for always being so nice to me.”

-satisfied patient

“Best experience I’ve ever had in a doctor’s office!”

-satisfied patient

“You have the most wonderful staff!”

-satisfied patient

“I would take a bullet for Dr Sewell”

-former nurse

If my face ever just falls off...I want YOU to sew it back on!”

-former nurse

©2019 - All Rights Reserved • High Valley Dermatology & Dermatologic Surgery