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Reading a Biopsy

From the Colorado Dermatology Institute in Colorado Springs, Colorado.
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Video Transcript

Here’s another daily tip from your friendly local dermatologist!

So I had a patient come in the other day and they said, “Hey Doc, I had a biopsy of something and it came back cancerous and the doc said they got it all in the biopsy and nothing else needs to be done.” Well, the answer is not really. Depends on the biopsy. So if they took a biopsy like we have a video of where they just are scraping the top off so it’s kind of a shave biopsy and they come back and say well the pathology report says it’s clear margins. We don’t have to do anything. My response to that is that when you take a shave biopsy you’re looking at less than 1% of the margin. So if you’re making a determination if more treatment is needed for a cancer on less than 1% of the margin I would say that that’s putting a lot of faith in less than 1%. I think they need to be treated. In fact, when you look at the studies when you have those shave removals and the skin looks completely normal on the outside after it’s healed. There’s still cancer underneath about 1/3 of the time. So think about that. Even when the skin looks perfectly normal to a dermatologist’s eyes who are trained to notice little subtleties of if there’s a cancer present or not, there’s still stuff lurking below the surface and that’s going to cause problems in the future. Now if they did a “biopsy” where they cut it out and stitched it up and had wide margins, well, chances are that you did get around it based off of the pathology report. But if it’s just one of these punch biopsies or a shave biopsy I would have a conversation with your local dermatologist because in my opinion it hasn’t been treated adequately.

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