Punch Biopsy or Shave Biopsy for a Suspicious Mole?

If the pigmented lesion is truly suspicious for melanoma, complete excision should be performed. If the pigmented lesion is too large or in a cosmetically sensitive area, an incisional biopsy can be performed. In that instance usually a punch of the darkest or most raised portion of the pigmented lesion is removed, leaving the rest of the pigmented lesion intact.

If a pigmented lesion is less suspicious for a melanoma, a shave removal can be performed. Shave removal may not remove all of the pigment cells so some lesions can recur, sometimes with varied colors. However, shave removal frequently works well for skin-colored lesions on the face.

If you are not happy with the results from the current doctor, perhaps you should consider seeking a second opinion or having somebody else perform the surgeries. There are also other procedures available now that help to determine if a biopsy is truly necessary for a pigmented lesion and may also help to detect melanoma at an early point. This would include dermoscopy or digital dermoscopy (e.g. Molemax) and other technology (e.g MelaFind). You might talk to your doctor about some of these options. Good luck.

Moles should be removed in total and submited for pathology.

Shave biobsy does not show the deeper portion of the mole to do a complete examination of the invasion of the melanocytes down the layers of the skin.

If malignant shave biobsy will not gove you a clear picture of the depth of invasion, and one loses that golden opportunity.