Skin Cancer Diagnosis and Staging

April 10, 2026

This page was reviewed under our medical and editorial policy by Gaurav Singh, M.D., M.P.H., F.A.C.M.S., Mohs Micrographic Surgeon and Dermatologist, City of Hope^® Cancer Center Chicago.

Patients with skin cancer may undergo a variety of tests that may help diagnose the type, extent and stage of their skin cancer. These tests may be conducted by dermatologists — who are skin health experts — or by skin cancer doctors. Diagnosing and staging skin cancer accurately helps a patient’s cancer care team create a personalized, effective treatment plan.

“The number one question patients ask me when they receive a skin cancer diagnosis is simply, ‘Am I going to be okay?’ In that moment, I address three things they are really asking beneath that one question: How early is it, what are we going to do about it, and will it come back?” says Gaurav Singh, M.D., M.P.H., F.A.C.M.S., Mohs micrographic surgeon and dermatologist at City of Hope^® Cancer Center Chicago. “I reassure them that in the vast majority of cases, particularly with basal cell and squamous cell carcinomas caught at a localized stage, we are in a very good position, and the prognosis is excellent.”

How Is Skin Cancer Diagnosed?

If a medical provider suspects that a patient may have skin cancer, the first step is often a physical examination of the skin. However, because an exam may only provide so much information, most patients also undergo a biopsy.

Skin Cancer Biopsy

There are many different types of biopsy, which is the term for any procedure that removes a tissue sample for examination in a lab for signs of cancer. The kind of biopsy that is used depends on a variety of factors, including the skin lesion’s location and size, as well as the patient’s overall health.

Excisional Biopsy

An excisional biopsy is a biopsy that removes (or excises) the whole skin lesion. During an excisional biopsy, a surgeon cuts away both the lesion and a small amount of surrounding healthy tissue. The wound is closed using stitches that stay in the body for about a week.

Incisional Biopsy

An incisional biopsy makes a smaller cut with a scalpel and removes a small amount — but not all — of a skin lesion. The wound is sealed with stitches for around a week. Incisional biopsy allows surgeons to take a tissue sample that may be tested for cancer in a lab. H4: Lymph Node Biopsy Doctors may recommend a lymph node biopsy if they believe that a patient has skin cancer that has spread to the body’s lymph nodes. This procedure involves removing some of the lymph nodes, which are part of the body’s lymphatic system, and examining the tissue samples for signs of cancer.

Punch Biopsy

A punch biopsy is a procedure that uses a surgical tool that removes a small (4-6 mm) circle of tissue from the skin. Stitches are generally utilized to close the area.

Shave Biopsy

A shave biopsy uses a special surgical tool that can slice off a thin layer of skin at the site of a skin lesion. This sample may then be examined in a lab. In most cases, the wound is closed without stitches, using a process called cauterization.

Imaging Tests

The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. These types of skin cancer do not usually spread beyond the skin. However, if a patient’s care team suspects that cancer may have spread to other tissue or to the lymph nodes, then imaging tests such as magnetic resonance imaging or computed tomography may be recommended.

Skin Cancer Stages

Different types of skin cancer are staged differently. Staging cancer refers to the process of using tests to determine the extent of a patient’s cancer. In some cases, skin cancers are assigned a stage number from Stage 1 to Stage 4, with higher stage numbers referring to more advanced cancers. In others, skin cancer may be referred to simply as low risk or high risk.

Learn more about the basal cell carcinoma stages

Learn more about the squamous cell carcinoma stages

Learn more about Merkel cell carcinoma stages

Learn more about melanoma stages