Diagnosing Melanoma
UT Southwestern’s skin cancer specialists offer the following tests to evaluate
and diagnose melanoma. All diagnostic tests help us determine the most
appropriate, evidence-based course of treatment.
- Biopsy: If a spot
on the skin appears to be cancerous or precancerous, a small sample of the
suspicious tissue is removed for microscopic evaluation by a
dermatopathologist. If melanoma is confirmed, additional testing is
conducted to determine its exact type and to identify any abnormal genes,
including the melanoma BRAF gene. Knowing the specifics of a
melanoma’s genetic makeup can sometimes help doctors determine the
treatment most likely to benefit each patient.
- Imaging:
Technologies such as computed
tomography (CT), positron
emission tomography (PET), magnetic
resonance imaging (MRI), and X-rays
might be used to determine if melanoma has spread to other parts of the
body.
Staging Melanoma
Our physicians determine a melanoma’s stage – the severity and extent to which
it has metastasized beyond the primary location – by considering these
factors:
- The
location(s) of the disease
- The
thickness and other features of the primary melanoma tumor
- Whether –
and to what extent – melanoma cells have spread to the lymph nodes or
other parts of the body
- The results
of a lactate dehydrogenase (LDH) blood test
Stages of Melanoma
There are five stages of melanoma:
- Stage 0 (in situ):
Pre-melanoma that has the potential to become melanoma
- Stage I: Early, localized disease
with no melanoma in the lymph nodes
- Stage II: Fairly early, fairly
localized disease that is slightly more advanced than stage I, with no
melanoma in the lymph nodes
- Stage III: Disease that has spread
to areas in the skin near the primary location or the lymph nodes near the
melanoma
- Stage IV (metastatic): Disease
that has spread via the lymph nodes or the blood stream to distant parts
of the body – most commonly the lungs, liver, bones, and brain.