During a skin exam with a Dermatologist the doctor uncovers one part of your skin at a time, looking closely at any unusual spots, patches, moles or lesions. If a biopsy is needed, the Dermatologist will numb the area, then remove all or part of the suspicious lesion, to be sent to a lab for examination. The Dermatologist will put a little ointment on the wound, cover it with a bandage and tell you that they will get the results in about a week.
1. How does my biopsy travel to a lab? It goes into a liquid preservative called formalin that “fixes” the tissue so it doesn’t change or degrade. The tissue is transported to the lab in a small jar bottle for overnight delivery.
2. Once it arrives, how is my biopsy handled in the lab? The biopsy specimen is logged in, and a technician processes it through various chemicals and embeds the tissue into paraffin wax, so it can later be sliced into extremely thin sections. Then, they put the sections on glass slides and apply stains which help the Dermatopathologist identify the type of cells on the slides under a microscope.
3. What happens under the microscope? It is a sight-driven process and often there is an instant recognition. If the diagnosis is not definite, the Dermatopathologist may use different stains to help pinpoint it.
4. When the Dermatopathologist has reached a conclusion, what’s the next step? A report about findings, including whether it is benign or a malignant carcinoma, and pertinent information is sent to the doctor. If it is a melanoma, the report includes detailed information about the depth of the tumor and qualities of the cells to determine its stage. The dermatologist will read the report and inform the patient about the results.
5. What happens to all those slides? After the doctor report is finished, the slides are numbered and filed for future retrieval, if necessary. State laws determine how long slides must be retained by the laboratories, which is often 10 years.
Knowing when and what to biopsy is an important skill set for a Dermatologist, but feedback and information from the Dermatopathologist help make the correct diagnosis. If you have a diagnosis of precancer or skin cancer, there are many treatment options available with our Fellowship trained Mohs Surgeon and Board Certified Dermatologist at Bluewater Dermatology & Skin Cancer Center.