What biopsy is indicated for suspected melanoma?

• A. Shave biopsy
• B. Curettage
• C. Excisional biopsy
• D. Aspiration for cytology

Answer: (C)

Melanoma prognosis and treatment rely on measuring how deeply the cancer has invaded the skin, which requires a full-thickness tissue sample that includes the entire lesion and some surrounding normal tissue. An excisional biopsy achieves this by removing the whole lesion down to the subcutaneous tissue with a small margin of normal skin. This provides complete architectural details and the Breslow depth that pathologists need to stage the tumor and guide management.

Shave biopsy only takes the surface and can miss the deepest part of the lesion, distorting depth measurements and margins. Curettage likewise removes superficial tissue and fails to yield reliable depth information. Aspiration for cytology yields individual cells without tissue architecture, so depth and invasion cannot be assessed. Therefore, the excisional biopsy is the best choice for suspected melanoma.