At Penn Medicine, our skilled melanoma team has experience recognizing the signs of melanoma in its early stages. If you have a higher risk of melanoma, we monitor you closely to check for precancerous skin changes. With advanced skin cancer screening, we find melanoma as early as possible so you can begin treatment right away.
Diagnosing Melanoma: The Penn Medicine Advantage
As part of Penn’s Abramson Cancer Center, the Tara Miller Melanoma Center is nationally known for exceptional care. Our program offers:
- Team of melanoma experts: Our highly trained doctors have years of experience in oncology (cancer care), dermatology, pathology (disease diagnosis), surgery and other fields. We bring together our expertise in weekly team meetings, where we review complex cases from all perspectives.
- Sophisticated testing: You’ll have a thorough evaluation, including a complete skin exam with an expert set of eyes. We use a variety of biopsy techniques and tumor mutation testing as appropriate. We may recommend whole-body photography to monitor skin changes over time.
- Personalized treatment: With an accurate diagnosis, we work closely with you to plan effective, personalized care. We offer the latest treatment options, including Mohs surgery, immunotherapy and targeted therapy, many of which can provide a cure. Learn more about melanoma treatments.
- Nationally recognized cancer care: The National Cancer Institute has designated the Abramson Cancer Center as a Comprehensive Cancer Center. This recognition highlights our commitment to the highest national standards for research and patient care. At Penn, you receive the most advanced care based on the latest research findings.
Melanoma Evaluation
Whether you come to us with potential symptoms or a confirmed diagnosis, we evaluate your situation thoroughly. We tailor the plan to you, but our cancer specialists begin by:
- Discussing your symptoms and possible risk factors
- Reviewing your personal and family medical history
- Ordering tests to confirm a diagnosis
Diagnosing Melanoma Skin Cancer
We do a physical exam and a complete skin exam to check for moles or suspicious skin growths. To closely examine your skin, our doctors use a dermatoscope, which has a special magnifying lens and light. We also offer whole-body photography to track skin changes over time.
Biopsy for melanoma skin cancer
If we see a suspicious-looking growth, we order tests to help us confirm a diagnosis. A skin biopsy is our main tool for confirming a diagnosis of melanoma skin cancer.
In a biopsy, we take a small tissue sample of the suspicious area. Our dermatopathologists (specialists in diagnosing skin diseases) examine the sample under a microscope for signs of melanoma.
We do several types of skin biopsy, including:
- Shave biopsy: The doctor removes the top few layers of skin in a growth.
- Punch biopsy: Using a tool with a tiny circular blade, we take a deeper tissue sample of all the layers of skin.
- Excisional biopsy: In this procedure, the doctor removes the whole growth and a small margin (border) of skin around it.
If a skin biopsy confirms melanoma, we do further tests to see if cancer has spread. When melanoma spreads, it usually travels to nearby lymph nodes. Lymph nodes are part of the lymphatic system, which helps filter waste, infections and other substances from the body.
Tests to check for cancer spread include:
- Fine needle aspiration biopsy: We use a syringe with a thin needle to take small samples of tissue. This test examines tissue from nearby lymph nodes.
- Sentinel lymph node biopsy: Near the tumor, we inject a dye that travels to nearby lymph nodes. The closest lymph node or nodes (sentinel nodes) pick up the dye. We remove those nodes and check them for cancer cells.
Other tests for melanoma skin cancer
These tests help guide your treatment planning:
- Tumor mutation testing: We recommend genetic testing of the melanoma tumor in anyone with advanced melanoma, which is stage 3 or higher. Advanced melanoma has spread from its original site to nearby tissue and distant areas of the body. Genetic testing can show if the tumor or melanoma has specific gene mutations (changes) that targeted therapy can treat. Find out more about tumor genetic testing available at Penn’s Center for Personalized Diagnostics.
- Imaging: We may use imaging to see if melanoma has spread to other areas of the body. Our advanced imaging technologies include CT scans, MRI scans, PET/CT scans and ultrasound.
Diagnosing Mucosal Melanoma
If we suspect mucosal melanoma in your initial evaluation, we take a biopsy to confirm a diagnosis. If the biopsy finds cancer cells, we may request MRI or CT scans to see whether cancer has spread.
Diagnosing Eye (Ocular) Melanoma
Ocular melanoma may not show symptoms early on. Your ophthalmologist may discover it during a routine eye exam. Additional tests that you might need include:
- Eye ultrasound: A handheld scanner uses high-frequency sound waves to produce images inside the eye to help diagnose ocular melanoma.
- Biopsy: Your ophthalmologist removes a small sample of tissue from the surface of the eye. Our pathologists examine the sample for signs of melanoma.
- Fluorescein angiography: We first inject dye into your arm. The dye travels to blood vessels in the eye. A specialized camera takes pictures of the retina (back of the eye) to check for any problems.
Second Opinions for Melanoma
An accurate diagnosis is critical so that you can get the right treatment as soon as possible. At the Tara Miller Melanoma Center, our melanoma specialists work together to confirm a diagnosis and recommend treatments. Learn more about getting a second opinion on your cancer with our team.
Request an Appointment
Call 800-789-7366 to schedule an appointment with one of our melanoma experts. You can also request an appointment using our online form.