Excision Biopsy (Moles, Corns, and Tumours)

During an Excision Biopsy for a mole, corn or tumour, your surgeon will remove the entire mass or the entire lump, along with an entire area of abnormal skin, as well as a small area of normal skin.

She will then close the biopsy site with stitches after the procedure. The amount of normal tissue taken, also called the clinical margin, depends on the thickness of the mole, corn, or tumour. Excision biopsies are best for detecting a melanoma. In the case of a possible melanoma, skin grafting or rotation flaps of skin from other sites is carried out after the excision biopsy. This may be used to cover the wound resulting from the wide local incision. However, most cutaneous melanoma incisions can be closed without a skin graft.

By examining and performing tests on the biopsy sample, pathologists and other experts can determine what kind of cancer, if any, is present, whether it is likely to be slow or fast-growing, and whether it has any genetic abnormalities. This information is best for deciding the type of treatment.

The major advantage of an excision biopsy is that it provides the pathologist with the entire lesion so that the chance that a cancer can be missed is minimal. The piece of tissue removed is then sent to the laboratory for analysis.

An excision biopsy is usually done when the abnormal tissue is relatively small in size and removing it will help relieve your symptoms, where it is benign or cancerous. The main advantage of an excision biopsy is that in one operation your surgeon can not only remove the tissue but can also come to a possible diagnosis, as opposed to an incision biopsy, where only a bit of tissue is removed, but the remaining tissue still needs to be treated.

Dr. S. Suma is extremely adept at performing excision biopsies. She will also reassure you as you may be nervous about a possible adverse diagnosis. She will work with you not only before and during your excision biopsy, but also later, during possible treatment.

Your doctor will determine whether you are the right candidate for an excision biopsy. If you have widespread disease, your surgeon may choose to avoid problematic areas that may result in scarring or an adverse outcome. For example, surgical sites below the knee have a higher risk of infection or delayed healing. Other unfavourable sites include the central face and the back of the forearm.

Excisional biopsies are best carried out for lesions on the trunk and limbs. Dr. S Suma will consult with you in detail before your excision biopsy. She will most likely take a detailed medical history, as well as conduct a detailed physical exam, especially of the affected site.

She may also take photographs of the mole, corn, or tumour for your medical record.

She may also ask you to refrain from taking certain medications such as aspirin-based products, certain anti-inflammatory drugs, blood-thinners and herbal supplements as these can cause bleeding. She may also ask you to stop smoking before your surgery as smoking delays healing.

You should ask Dr. S. Suma any and all questions you may have regarding your excision biopsy. She will not only work with you before your surgery, but will also reassure you as to the results after your surgery.

If your mole, corn, or tumor is large, you may need to be admitted into the hospital and the excision biopsy will need to be performed under a general anesthetic. If an accessible part of your body, such as your mouth or skin are affected, you may not need to be admitted to the hospital, and the operation can be carried out in an outpatient facility under a local anesthetic with sedation. Your doctor will determine the extent and size of the biopsy, as well as the type of anesthetic.

Your surgeon will mark the area of the excision biopsy with a surgical marker. Two small triangles are then drawn on either side of the lesion to mark the area of the surgical incision. The incision should be long, thin, and linear and should follow the natural contours of the skin.

After the biopsy, the wound is closed with both deep and superficial sutures. Layered closure is employed with absorbable deep sutures and non-absorbable superficial sutures. If the wound is not under tension, adhesive tapes or tissue adhesive can be used in place of the superficial sutures.