A shave biopsy is a reasonably safe and accurate method for the initial diagnosis of melanoma, according to a study published in the April issue of the Journal of the American College of Surgeons. In the past, some physicians have criticized shave biopsies for not providing accurate T (tumor) stage information, thereby complicating treatment planning.
"We conducted this study to determine the impact of shave biopsies on the initial staging of melanoma and their impact on the final treatment planning for patients," explained Jonathan S. Zager, MD, FACS, associate professor at the Moffitt Cancer Center, Tampa, FL, and lead author of the study. "Shave biopsies are commonly used by dermatologists, primary care physicians, and surgeons as a less invasive and more efficient means of biopsying suspicious lesions for diagnosis."
In the largest study to date, researchers at Moffitt Cancer Center and the University of Florida Shands Cancer Center, Gainesville, retrospectively analyzed 600 consecutive patients who underwent a shave biopsy for suspicious skin lesions between 2006 and 2009. They found presumptive pre-shave diagnosis of melanoma was suspected in only 25% of these patients. After definitive surgical wide excision was performed, 133 (22%) had residual melanoma in the surgical excision specimen. However, the detection of residual melanoma in these patients only resulted in subsequent upstaging in T-stage in a small group of 18 (3%) patients, showing that T-stage and depth data obtained through shave biopsy were accurate in 97% of all patients.
[Source: Science Daily]