Skin cancer is a serious dermatologic issue on a global scale—and one that healthcare providers need to be adequately prepared to address with patients.
The standard pathway for a skin cancer screening tends to be visual, starting with a dermoscopic assessment of the questionable lesion, which is then followed by biopsy and histopathologic evaluation. This, however, has changed over the years, as new and innovative diagnostic technology has been developed.
It’s estimated that globally, one million new cases of non-melanoma skin cancer and nearly 300,000 new cases of malignant melanoma were diagnosed in 2018. Five-year survival rates have increased, though, and when detected and treated early, the survival rate of common forms of non-melanoma skin cancer is 95 percent. As such, you want to ensure that your practice offers the most effective and efficient technology for diagnosing skin cancer—helping provide your patients with better long-term outcomes.
Read on to gain insight on how non-invasive technologies compare to traditional biopsy to ensure your practice is offering the most successful patient care.
Traditional Biopsy
A biopsy is a more invasive option for skin cancer diagnosis, as it removes a sample of tissue from the body for closer assessment. There are many types of biopsies, but the three primary are:
Shave Biopsy: Only a small section of the top layers of the skin is removed with a razor-like tool.
Punch Biopsy: This involves taking a deeper sample of the skin using a circular tool.
Excisional Biopsy: A scalpel is used to fully remove the lump or the abnormal area, including a portion of the normal skin, down into the fatty layer of skin.
And while a biopsy is a relatively safe procedure, there are some potential adverse effects, including:
Bleeding
Bruising
Infection
Allergic reaction to the topical antibiotic
It’s additionally likely that your patient will be left with necessary follow-up care, with healing sometimes taking several weeks or even up to two months. All biopsies also result in scarring, which can range from a small scar to a more prominent raised scar.
Plus, timing may be delayed with a biopsy, as depending on the skin condition and type of biopsy, lab results can take several days—or even a couple of weeks—slowing down the ability to immediately begin accurately treating your patient.
Reflectance Confocal Microscopy
The reflectance confocal microscopy (RCM) technology uses a low-power laser to scan skin lesions and utilizes the reflectivity of different cellular elements in the lesion to offer insight on whether a site is cancerous. This technology essentially offers a “virtual biopsy” of the skin.
RCM can be used to diagnose both benign and malignant skin lesions, including melanoma, BCC and SCC. The depth of imaging, though, is limited to 200-300 micrometers, which is adequate for assessing the papillary dermis and upper reticular dermis—but not for lesions or inflammatory processes that are deeper.
This imaging technology does help eliminate the need for unnecessary biopsies, as it can identify what is suspicious and what is not—and then only suspicious areas will need to be followed-up with a biopsy to confirm diagnosis. Additionally, because it is a non-invasive approach, the same area can be examined multiple times without risk of physical damage, including damage to the tissue.
However, the RCM instrument is bulky and can be difficult to use in small areas, limiting its usage. Timeliness is also an issue with this technology, as results still need to be routed electronically for examination and diagnosis by a doctor. It is estimated that a minimum of four to six months of training is needed—including evaluating thousands of cases—for a clinician to be an expert of diagnostic accuracy.
This need for extensive training to interpret the images can slow down the diagnostic process and potentially monopolize practice resources, making the process of patient diagnosis longer than needed.
Visual Inspection and Dermoscopy
A dermoscopy refers to assessment of the skin using a skin surface miscroscopy, and it is often used to evaluate pigmented skin lesions. This tool is becoming more prominently used in primary care settings by aiding in the diagnosis of melanoma.
Studies suggest that the dermoscopy is more accurate than just a visual inspection of the questionable area of skin—both for identifying BCC correctly, as well as for excluding skin ailments that are not BCCs. It additionally offers value above visual inspection when it comes to BCC and SCC diagnoses, including:
Reassurance to those with benign skin lesions who do not need further care
Identification of low-risk cancers that can potentially be treated by primary care
Identification of higher-risk cancers that will need to be referred to secondary care
That being said, limitations do exist, even for trained dermatologists. While dermoscopy typically offers no complications, there is a risk of cross-infection between patients that providers need to adequately prepare for. Additionally, featureless melanoma are melanoma lesions that can be overlooked during both visual examinations and dermoscopy—a limitation that was originally acknowledged in 1996 when it was noted that eight percent of melanomas evaded dermoscopic detection.
Therefore, while a dermoscopy offers diagnostic benefits, its usage should be for aiding in clinical assessment and diagnostic decision making.
The New Approach: Spectra-Scope®
It’s well known that skin cancers, especially melanoma and SCC, present higher risks when left untreated for extended periods—so why are some common skin cancer diagnostic technologies slow in assessment?
Fortunately, instantaneous skin cancer diagnoses are now accessible through a diagnostic solution based on artificial intelligence (AI) technology and laser-induced plasma spectroscopy (LIPS)—helping support necessary rapid diagnoses for your patients. The Speclipse Spectra-Scope® is a groundbreaking technology that’s diagnostic accuracy has been proven by worldwide clinical studies in Australia and the United States.
With this technology, identification of skin cancers (BCC, SCC and malignant melanoma) versus benign lesions were accurately diagnosed with 97.6% sensitivity and 86.2% specificity. Additionally, challenging lesions can be verified by this technology—helping avoid unnecessary biopsies of benign lesions.
Spectra-Scope® provides better clinical decisions prior to any excision through enhanced accuracy, efficiency and verification.
The Spectra-Scope also offers long-term value to your patient care, as information about skin lesions previously assessed with the technology is organized and stored. This offers you easy access and understanding of the clinical history of a specific lesion—providing more efficient tracking of the clinical history for enhanced diagnosis and treatment.
Give your patients accurate and rapid oncological results—without the scarring. Discover the Spectra-Scope today and contact us to learn how you can offer your patients state-of-the-art skin cancer diagnostic technology.