A critique of techniques for biopsy of clinically suspected malignant melanomas

Two hundred twenty-seven malignant melanomas, exclusive of malignant melanoma in situ, were diagnosed in the Dermatopathology Laboratory of the New York University Medical Center in a 7-month period. Of these, 143 had been suspected of being malignant melanomas by the clinicians who submitted them. These lesions had been biopsied in various ways by surgeons and dermatologists, of whom those trained more than 10 years ago were found more likely to have done scalpel excisions, whereas dermatologists trained within the past 10 years had more likely done shave or punch biopsies. All too often, dermatologists failed to perform satisfactory biopsies of lesions that they suspected to be malignant melanomas clinically.