Melanoma Diagnosis and Staging

Appointment New Patient Appointment or 214-645-8300

Diagnosing Melanoma

UT Southwestern’s skin cancer specialists offer the following tests to evaluate and diagnose melanoma. All diagnostic tests help us determine the most appropriate, evidence-based course of treatment.

  • Biopsy: If a spot on the skin appears to be cancerous or precancerous, a small sample of the suspicious tissue is removed for microscopic evaluation by a dermatopathologist. If melanoma is confirmed, additional testing is conducted to determine its exact type and to identify any abnormal genes, including the melanoma BRAF gene. Knowing the specifics of a melanoma’s genetic makeup can sometimes help doctors determine the treatment most likely to benefit each patient.
  • Imaging: Technologies such as computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI), and X-rays might be used to determine if melanoma has spread to other parts of the body.

Staging Melanoma

Our physicians determine a melanoma’s stage – the severity and extent to which it has metastasized beyond the primary location – by considering these factors: 

  • The location(s) of the disease
  • The thickness and other features of the primary melanoma tumor
  • Whether – and to what extent – melanoma cells have spread to the lymph nodes or other parts of the body
  • The results of a lactate dehydrogenase (LDH) blood test

Stages of Melanoma

There are five stages of melanoma:

  • Stage 0 (in situ): Pre-melanoma that has the potential to become melanoma
  • Stage I: Early, localized disease with no melanoma in the lymph nodes
  • Stage II: Fairly early, fairly localized disease that is slightly more advanced than stage I, with no melanoma in the lymph nodes
  • Stage III: Disease that has spread to areas in the skin near the primary location or the lymph nodes near the melanoma
  • Stage IV (metastatic): Disease that has spread via the lymph nodes or the blood stream to distant parts of the body – most commonly the lungs, liver, bones, and brain.