Cutting It Close

Although the recommended biopsy technique for pigmented lesions is excision with narrow margins, punch or shave biopsies are commonly employed. However, the accuracy of these sampling methods is not clear. Investigators in Australia conducted a large study to establish the effectiveness of punch or shave biopsies for diagnosing melanoma.

The researchers compared initial pathology reports of 2127 excisional biopsies, 163 punch biopsies, and 180 shave biopsies performed in patients referred to a melanoma service from 1995 to 2006, with definitive excisions performed by the tertiary service. They classified 2252 diagnoses as correct (91.2%); 135 as false-positive misdiagnoses (5.5%); and 83 as false-negative misdiagnoses (3.4%), including 37 (1…