When the entire tumor is removed, the procedure is called an excisional biopsy. If only a portion of the tumor is removed, the procedure is referred to as an incisional biopsy. When possible, excisional biopsy is the preferred method when melanoma is suspected.
An excisional biopsy, also called a wide local incision, involves surgical removal of a tumor and some normal tissue around it. The amount of normal tissue taken (also called the clinical margin) depends on the thickness of the tumor. In the case of possible melanoma, skin grafting (taking skin from another part of the body to replace the skin that is removed) or rotation flaps of skin from other sites may be used to cover the wound resulting from the wide local excision, but most cutaneous melanoma excisions can be closed without placement of a skin graft.