How Stage 0 is Diagnosed

Step 1: Physical Examination

The patient should get a physical examination of the entire skin area and the lymph node areas near the suspected melanoma.

Learn more about the doctor's examination

Step 2: Biopsy

In a skin biopsy, a portion of the lesion or the whole lesion is removed, along with an area of surrounding normal skin.  If the whole lesion isn’t removed, then the thickest part of the lesion is removed, including the full depth of the lesion. This is usually done in the doctor’s office.

The tissue sample from the biopsy is sent to a pathologist, a doctor specially trained in the microscopic examination and diagnosis of tumor samples. The pathologist will do the following:

  • Determine whether the lesion is benign or malignant
  • Measure the thickness of the lesion (using the Breslow Depth)
  • Note how deeply it grows into the underlying normal tissue (Clark Level)
  • Check whether the lesion is ulcerated. In ulceration, the epidermis (outer layer of the skin) that covers a portion of the lesion is not intact
  • Check the mitotic count to see how many cells are actively dividing
  • Look for cancer at the edges of the biopsy
Learn more about skin biopsies

Step 3: Tests to Make Certain

Usually for Stage 0 disease, additional screening testing is not performed. Some doctors will screen with a chest x-ray and a blood test, but, because the chances of finding distant disease is very low, more invasive tests that have some degree of risk are not typically done.

  • X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs
  • Blood tests. Blood may be tested to help determine if the cancer has spread
Learn more about the diagnosis of melanoma
Learn about determining the stages of melanoma

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