Fine-needle biopsy as a diagnostic technique for metastatic melanoma

Fine-needle biopsy (FNB) is a rapid, minimally invasive technique, widely used for the investigation and diagnosis of lesions in a variety of body sites. It is a procedure with high diagnostic accuracy for metastatic melanoma, with a sensitivity of 92.1% and a specificity of 99.2% in a recent large study. Although at present FNB has virtually no role in the initial diagnosis of pigmented primary cutaneous tumors, recent evidence suggests that it should be the first-line diagnostic modality for confirmation of clinically and/or radiologically suspected metastases in melanoma patients. As the specimen procured by FNB can be examined within minutes of performing the procedure, an on-demand FNB service with rapid communication of results to the patient's treating clinician enables a more efficient and cost effective approach to the multidisciplinary management of melanoma patients. In the future, it is likely that molecular analysis of very small amounts of tumor tissue obtained by FNB will provide an accurate estimate of prognosis and will facilitate selection of patients who may benefit from targeted molecular therapies.