How SCSC is Diagnosed

How is Squamous Cell Skin Cancer Diagnosed?

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 that 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.