Fine-needle biopsy of metastatic melanoma: clinical use and new applications

Fine-needle biopsy (FNB) is a minimally invasive and accurate means of diagnosing metastatic melanoma. The judicious use of FNB, with a multidisciplinary approach involving pathologists, radiologists, treating clinicians, and other health professionals, can achieve efficient and cost-effective management of patients with melanoma who are suspected of having metastatic disease. The FNB procedure is well-tolerated and has the potential to readily provide fresh tumour material for the performance of molecular, genetic, and proteomic analyses. These analyses are likely to become more important in the future for the diagnosis of metastatic melanoma, for establishing prognosis, and for identifying patients with metastatic melanoma in whom targeted therapy (so-called personalised treatment) is most likely to be effective. In this review, the role of FNB as an important diagnostic modality in the management of suspected metastatic melanoma is described and other diagnostic and research applications of FNB are discussed.