If you or your health care provider suspects you have squamous cell skin cancer (SCSC), you will often be referred to a dermatologist, which is a doctor who specializes in diseases of the skin. When you meet with your dermatologist, s/he will likely take a medical history, perform a physical examination, examine any areas of concern, and decide whether a skin biopsy is warranted.

If a biopsy is necessary, a sample of the suspicious area will be taken for microscopic evaluation. Before removing a sample of the suspicious lesion, your skin will likely be numbed so that discomfort is minimized.

Once a biopsy is taken, it is sent to a laboratory so that a specialist can examine how the skin cells look under a microscope. For skin cancer, the specialists who examine the biopsied tissue under a microscope to diagnose skin disease are called pathologists or dermatopathologists. Biopsies are the fundamental ‘gold standard’ for diagnosing skin cancer because this method provides a high level of certainty.

When your medical provider receives the pathology report of the biopsy, s/he should discuss with you what additional steps might be necessary.

If a diagnosis of SCSC is made, a complete head-to-toe skin examination to look for other suspicious spots is usually recommended for follow-up. The goal is to find and remove other lesions before they become problematic. For SCSC, precancerous lesions include actinic keratoses, which are the scaly, rough skin formed after long-term exposure to the sun. People who are diagnosed with SCSC also have a high risk of having additional skin cancers at different skin sites, including melanoma and basal cell carcinoma. Therefore, additional skin biopsies may be taken of suspicious areas.