The Doctor's Examination
Here is what to expect when you schedule a visit to your doctor after detecting skin changes:
Complete Medical History
The doctor will first take a complete medical history to learn about your symptoms and risk factors. You will be asked your age, when you first discovered the area of concern on your skin, and if any features of that area have changed since your discovery. The doctor will ask about past exposures to known causes of skin cancer, such as sun exposure. You will also be asked whether you or your family have a history of atypical moles or skin cancer, particularly melanoma.
Complete Skin Examination
You will be asked to undress completely and be given a gown. The suspicious mole or lesion will be evaluated with the naked eye for size, shape, color, texture, and any evidence of bleeding, oozing, or scaling. The doctor will then perform a thorough and systematic examination of the rest of your body to check for other spots or moles that may be related to your skin cancer. This will include scalp, nails, palms, soles, ears, and areas not exposed to the sun, including beneath the breasts or under any rolls of flesh
Lymph Node Evaluation
The doctor will palpate (feel) the lymph nodes nearest the suspicious lesion, (in the groin, or underarm, or neck). If the nodes are enlarged or unusually firm, additional tests may be recommended to evaluate whether cancer has spread to the regional lymph nodes.
A doctor who suspects that a skin spot is melanoma will perform a biopsy. In this procedure (usually performed with a local anesthetic to numb the area), the doctor removes the suspect lesion using techniques that preserve the entire lesion so that the thickness of the potential cancer and its margins (healthy tissue around the lesion that is removed to make sure no cancer cells remain) can be carefully examined.
Any skin samples taken by a biopsy or an excision are sent for microscopic examination, and a pathology report is issued by the pathologist (a doctor who specializes in interpreting and evaluating cells, tissues, and organs to diagnose disease). The pathology report describes many aspects of the melanoma, including the size, the thickness of the lesion, the mitotic rate, and the presence or absence of ulceration, lymphatic response, regression, satellite lesions, and blood/nerve invasion.