Cancerous Lesion - Excision

This procedure includes the biopsy and removal of a skin cancer. The wound is then repaired and closed using several layers of sutures.

This procedure includes the biopsy and removal of a skin cancer. The wound is then repaired and closed using several layers of sutures.

Skin cancer refers to the growth of abnormal (cancerous or malignant) skin cells. Most skin cancers are one of three types:

  • Basal cell carcinoma is the most common type of skin cancer. It can appear anywhere on the body, but often appears as a pink nodule on the nose, cheek or chin. It is very rare for basal cell carcinoma to spread to another area of the body.
  • Squamous carcinoma is often found on the lip or ear. It can appear as a nodule or open sore and rarely spreads to another area of the body.
  • Melanoma is the least common, but the most serious type of skin cancer. It often looks like an irregular mole. It is usually more than one shade of black, brown or gray. The best chance for a good outcome is early removal. Once a melanoma has grown into the tissue under the skin, it can spread just like other serious cancers.

Basal cell and squamous cell carcinoma are often lumped together in a category called, “non-melanoma skin cancer.”

A skin biopsy is the removal of part, or all of a suspicious skin lesion. Depending on the size and location, a variety of methods can be used. Most removals are done after injection of a numbing medication into the area (local anesthesia).

  • Shave biopsy is the removal of a thin slice off the top of the lesion. Any bleeding is stopped with cautery. This biopsy is not a good choice for suspected melanomas.
  • Punch biopsy is like a tiny cookie-cutter that removes a small round piece of skin. Sutures and/or cautery may be needed.
  • Excisional biopsy is removal of the entire lesion. Sutures are then used to close the wound. This is the best method for suspected melanomas or lesions that are irritating and/or bleeding.
  • Incisional biopsy is when a lesion is too big to remove. It involves taking a pie-wedge piece of normal and abnormal skin for testing. Sutures and/or cautery may be needed.

All biopsies are sent to a pathologist in a lab for examination under a microscope.

IIf a biopsy is positive for skin cancer, additional surgery is often needed.

  • Most smaller cancers can be removed in an office or outpatient setting.
  • Larger sized lesions may require some type of skin graft to close the wound.

Skin cancers can occur anywhere on the body, no matter what your skin color or ethnicity is. They can even occur where the sun never reaches. Some of the risk factors for skin cancer are:

  • Frequent or long term sun exposure - even a single bad sunburn can increase your lifetime risk of melanoma
  • Many moles or moles that are large
  • Increased age
  • Fair complexion, freckles, red or blond hair and blue or green eyes
  • Family history of melanoma
  • Immune system weakness (from disease or certain medications)
  • Tanning in a tanning booth

It is important to remember that anyone can get skin cancer, even if they don't have any risk factors.

Some of the signs of skin cancer include lesions on the skin that are:

  • Scaly, shiny, or waxy
  • Firm, red, or rough
  • Different on one side than the other (asymmetrical) or have edges that are irregular
  • Oddly colored (can be brown, black, red, white, or blue)
  • Large, typically bigger than an eraser on a pencil
  • Not healing and tend to bleed
  • Changing or look different

Contact your healthcare provider if there are any changes in a skin lesion or any of the above signs of skin cancer. He or she may recommend a skin biopsy and/or removal of the lesion.

Prior to the procedure you should tell him or her about any medications you are taking (including over-the-counter medications and supplements). You should also ask if there are any specific instructions you should follow before and after the procedure. These may include:

  • Medications you should not take before the procedure, such as blood thinners
  • Regular medications you should continue to take on the day of your procedure

In most cases, a surgeon will close the wound right after the removal of the cancerous lesion.

  • In some cases, a plastic surgeon may need to close the wound at a later time.
  • In that case, you will receive a separate bill from the dermatologist and plastic surgeon.

What should I ask my healthcare provider before having a cancerous lesion removed?

  • What type of skin cancer do I have?
  • What other treatment options are available to me?
  • Do I need to see a dermatologist or plastic surgeon?
  • Will I need to see a medical oncologist (cancer doctor)?
  • What are the possible complications?
  • How should I care for the wound?
  • What are the follow up plans?

After your procedure, you should know what you had done, what medication was given (if any), and what symptoms you should report to your healthcare provider. You should also understand all home care instructions (including medications and side effects) and follow-up plans.


Also known as:

Cancerous Lesion - Excision
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