The first symptom of melanoma is usually a change in an existing mole, or a new mole that has certain features. Experts suggest using the "ABCDE rule" to help spot possible melanoma. Talk with your doctor about any mole that has any of the following qualities:
- A for asymmetry: One half is shaped differently than the other
- B for border: The mole has a jagged or irregular border
- C for color: The mole has different colors
- D for diameter: The mole is larger than the size of a pencil eraser (¼ inch)
- E for evolving: A mole changes its size, shape or color
Diagnosis
If your healthcare provider suspects you may have melanoma, they will order exams and tests. They will also do a physical exam and ask you questions about your health history, risk factors, symptoms and family history. Diagnostic tests may include the following:
- Full-body skin exam: Your doctor will check your skin for areas that look abnormal in color, size, shape, or texture.
- Skin biopsy: If any areas look suspicious, your doctor will remove some of the cells from this area so they can be examined under a microscope for signs of cancer.
- Imaging: If there is concern that melanoma may have spread beyond the skin, your doctor may order an ultrasound, MRI, CT or PET-CT scan for further evaluation.
- Total body photography with mole mapping: The Melanoma Risk and Prevention Clinic at Dana-Farber Brigham 91精品 offers artificial Intelligence-assisted total body photography with mole mapping to patients. This technology can help detect melanoma at earlier stages, improving survival rates, and reduces the need for invasive surgery.
- Reflectance confocal microscopy (RCM): This cutting-edge technology utilizes high-resolution, non-invasive imaging to aid in the diagnosis and management of melanoma by providing enhanced diagnostic accuracy.
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Stages of Melanoma
After being diagnosed with melanoma, our pathology and clinical team will determine the stage of your cancer. The stage is based on how deeply the cancer has grown into your skin, other characteristics of the tumor under the microscope, and if it has spread to lymph nodes or other areas of your body.
The most common way to stage melanoma is by using the TNM system from the American Joint Committee on Cancer (AJCC). Staging is very complex, but generally the higher the number, such as stage IV, means a more advanced cancer.
These are the stage groupings of melanoma and what they mean:
- Stage 0: The melanoma is only in the epidermis (the top layer of skin). This stage is also called melanoma in situ.
- Stage I: The cancer is not more than 2 mm thick and may be ulcerated. It has not spread to the lymph nodes or other areas of the body.
- Stage II: The cancer is at least 1.1 mm thick and may be ulcerated. It has not spread to lymph nodes or other areas of the body.
- Stage III: The cancer may be any thickness and may be ulcerated. It has spread to nearby lymph nodes or small melanoma tumors may be found in nearby skin or lymph vessels.
- Stage IV: The cancer may be any thickness, and it may be ulcerated. It may have spread to nearby lymph nodes, but it has also spread to distant lymph nodes or to other organs in the body, such as the lungs, liver or brain.
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