Is a Punch Biopsy Enough for Atypical Moles?

asked 6 months ago by hkwak002
Latest answer by Gary Goldenberg, MD
Question viewed 328 times
Tags: atypia, biopsy, shave

I had a few shave biopsies done 2 weeks ago. Two came back with mild atypia. The PA said they would do a punch biopsy to get the rest out. I asked if I could do an excision and she said its not really necessary. That the punch biopsy would get a wider and deeper sample and the margins would be tested. Is this enough of a precautionary measure to prevent this atypical mole from coming back/turning into melanoma? Btw I'm Asian, dark hair, have about 25 moles on body, no family history. Thank you.

5 answers to Is a Punch Biopsy Enough for Atypical Moles?

Punch biopsy for mild atypia

This is more than enough. In fact, I don't recommend removal of mild atypia at all. Despite what plastic surgeons will tell you, these lesions don't need to be removed. Moreover, if you look at medical literature, shave biopsy is a perfectly appropriate tool for diagnosis. Go see a dermatologist for follow up and make sure to use sunscreen.

Gary Goldenberg, MD
New York Dermatologist

Mildly Atypical Moles

How to proceed in a patient whose mole's biopsy report has been diagnosed as mildly atypical, depends on the philosophy of the dermatologist. Atypia can be either architectural or cellular. Architectural disorder means that there are some irregular features in the general shape and configuration of the mole. Cellular atypia means that some of the cells may have a nucleus that is too large for the size of the cell, or the nucleoli look off-color. Cellular atypia is more serious than... more

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

How to treat atypical moles

A shave biopsy is often the best way to go to have a mole checked for cancer. If the biopsy results show it to be cancerous or pre-cancerous then a second step, a complete excision with uninvolved margins, is necessary to ensure its complete removal. For relatively small moles, especially those that are only "mildly atypical", a punch biopsy may be all that is necessary to get clear margins. This will be determined by the biopsy report. In our office we will do an excision... more

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon

dorsetstreetdermatology.com

Punch biopsies OK for atypical moles with exceptions

For small, mildly, atypical moles, using a punch biopsy to remove the entire nevus is reasonable. The specimen will be reviewed by a pathologist to confirm that the margins are clear. Larger, atypical moles often require excisions because the punch biopsy instrument may not be large enough to completely remove the lesion. Severely atypical moles are often treated like melanoma in situ (the earliest form of non-invasive melanoma), and excised with 5 mm margins. Your... more

Naomi Donnelley, MD
Santa Barbara Dermatologist

Atypical mole

The PA can not be more wrong. You have atypical moles by shave biobsy. Moles should be completely excised No shaving of moles , only complete excision of moles. Shaveing of moles will interfer with staging of melanoma, and you would loose that opportunity which is important in planning for treatment. Puch biobsy does not examine the entire mole. Find a plastic surgeon to excise your moles and submit for pathology testing.

Samir Shureih, MD
Baltimore Plastic Surgeon

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