Having tests for melanoma

If you are worried about a mole or any new marks on your skin, you should see your GP. If they think it might be a melanoma, they will send you to a specialist doctor at the hospital. The doctor will be a dermatologist or plastic surgeon.

If there is any possibility it could be a melanoma, your specialist will advise you to have the mole removed. This is called an excision biopsy. After removing the mole, the doctors will examine it under a microscope to find out if it is a melanoma.

Most melanomas do not spread. If it does, it usually goes to the closest lymph nodes. You may have a CT or MRI scan to check whether melanoma has spread to the lymph nodes. You may also have these further tests:

  • Fine needle aspiration (FNA) – examining fluid from the lymph node.
  • Ultrasound scan – using sound-waves to build up a picture of the lymph nodes.
  • Sentinel lymph node biopsy (SLNB) – finding and removing the sentinel lymph node to check for cancer cells.

Visiting your GP

If you are worried about a mole or any new marks on your skin, you should see your GP. They will examine the mole. If they think it might be a melanoma, they will send you to a specialist doctor at the hospital. You should see a specialist within 2 weeks.


At the hospital

Your appointment will be at a skin clinic or a special clinic for diagnosing melanomas early (pigmented lesion clinic). You will see a skin specialist (dermatologist) or a plastic surgeon. They are both experienced in treating skin cancers. You might also see a specialist skin cancer nurse for more support.

The specialist will examine your mole and ask how long you have had it and how it has changed. Your specialist will find out a lot just by looking at the mole and listening to what you say. They may look at your mole with a small instrument called a dermatoscope. This is not painful and gives a bigger, clearer picture of the mole.

If there is any possibility it could be a melanoma, your specialist will advise you to have the mole removed. This is called an excision biopsy.

Excision biopsy

First, the doctor injects a local anaesthetic around the mole. This makes the area go numb, so you won’t feel anything. Then they cut out the mole and a tiny amount of normal skin around it. They close the area up with stitches. The doctor will remove the stitches after a week or two. Or they might dissolve by themselves.

After removing the mole, the doctors will examine it under a microscope to find out if it is a melanoma. This is called a biopsy.

You will have to go back to the clinic a few weeks later to get the results. If it is a melanoma, you will usually need to have some more tests (see below) and then further surgery.

When melanoma is treated early, it is usually cured.

Further tests

Most melanomas do not spread. If it does, it usually goes to the closest lymph nodes.

You may have a CT or MRI scan to check whether melanoma has spread to other parts of the body.


Tests to check the lymph nodes

Lymph nodes help your body fight infection and disease. They are small and bean-shaped. There are groups of lymph nodes around the body. They are connected to each other by a network of tiny tubes that carry a fluid called lymph.

Your specialist might suggest you have tests if:

  • the lymph nodes nearest to the melanoma look or feel swollen
  • you have had treatment and are at risk of the melanoma coming back.

The doctor will explain which tests they think you should have.

Fine needle aspiration (FNA)

The doctor gently puts a fine needle (attached to a syringe) into the lymph node and takes some fluid. The test can be a little uncomfortable, but it is over quickly.

The fluid is then examined under a microscope to see whether there are any cancer cells.

Ultrasound scan

An ultrasound scan uses sound-waves to build up a picture of the lymph nodes and the area around them.

Sentinel lymph node biopsy (SLNB)

When lymph fluid drains from the area of the melanoma, the sentinel lymph node is the first lymph node it drains to. If an SLNB is right for you, you usually have it at the same time as having surgery to treat the melanoma.

To find the sentinel node, the doctor injects a tiny amount of harmless radioactive liquid near the area of the melanoma.

Step 1: radioactive liquid is injected
Step 1: radioactive liquid is injected

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Next, they inject a blue dye. The dye stains the sentinel lymph nodes blue so the surgeon can see them (see below).

Step 2: blue dye is injected
Step 2: blue dye is injected

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The surgeon will use a probe that detects radioactivity to help them find the sentinel lymph nodes. The nodes are removed through a small cut in the skin. They send them to a lab to be checked for cancer cells. If there are no cancer cells in the sentinel node, the other lymph nodes are usually always okay.

Step 3: the sentinel lymph nodes are removed
Step 3: the sentinel lymph nodes are removed

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Having lymph node tests

If you need any of these tests, your specialist or skin nurse will tell you more about them.

If the tests are positive, your specialist may suggest an operation to remove all the lymph nodes in that area. This is called a lymph node dissection. The specialist will explain the operation to you and discuss the benefits and disadvantages.

We have more information about surgery for teenagers and young adults. We also have information for people of all ages, see our general surgery section.


Waiting for test results

Waiting for test results can be scary. Remember that you do not have to keep your worries to yourself. You could talk about how you feel and get support from family, friends or your specialist nurse and doctor. You could also talk to us on our free helpline on 0808 808 00 00, Monday to Friday, 9am to 8pm. You can also visit our online community to share experiences and ask questions.

Back to Melanoma

What is melanoma?

This section is for teenagers and young adults. It is about a type of skin cancer called melanoma.

Treatment

Melanomas in young people are usually found early and cured. Surgery is the most common treatment for melanoma.

After treatment

Cancer can have a big impact on your life, even after you have finished treatment.