The management of melanoma is determined by the depth of the melanoma at the time of diagnosis. To determine the depth of the melanoma, in the majority of cases, your doctor will need to perform an excisional biopsy. This involves excising the entire lesion so our expert pathologists can thoroughly assess the whole lesion. Once the depth of the lesion is reported back to us then the next steps in management will be discussed.
For around 80-90% of the melanomas diagnosed by our doctors, the only next step will be to perform a wider excision. This is not because the doctor missed any melanoma on the first excision; it is because if a wider excision is not performed there is an increased risk of a recurrence at the site of the original excision. Due to local spread around the melanoma.
For about 10% of our patients that have a melanoma diagnosed by our doctors, the melanoma is found to be more than 1mm deep. For this you may be referred to the Melanoma Unit at the Mater Hospital or one of the local Melanoma Surgeons. These patients will likely have their wider excision performed by a general surgeon, at the same time as having a local lymph node sampled and sent to the pathologist for assessment of spread of the melanoma. Further imaging tests may also be arranged.
As you can see there is a major advantage to having your melanoma diagnosed early. If your melanoma is diagnosed early by our dermoscopy trained doctors at Newcastle Skin Check then there is a very high likelihood your management will involve a simple excision all carried out by our surgically skilled doctors and that no further tests, referrals, or operations will be required.