Biopsy Technique for Moles
Almost universally surgeons recommend that an excisional biopsy be used when removing moles that are worrisome for melanoma. This type of biopsy removes the entire mole and the surrounding skin down to the the level of fat.
If the biopsy does come back as a melanoma this type of biopsy allows the pathologist to determine how deeply into the skin the melanoma has penetrated (the Breslow level). This is important in determining the aggressiveness that is needed for the next operation and also in determining the prognosis.
Unlike surgeons, many dermatologists prefer to do a shave biopsy on moles. This is done by using a tiny, sharp, spoon-like device to shave off the top of the mole. It is easier and faster to perform and usually does not require stitches. But, if the biopsy comes back as a melanoma the opportunity to tell how deep the melanoma is has been lost.