U.S. doctors biopsy about two million possible melanomas each year and diagnoses are uncertain in 280,000 (14%) of them. Now, a new test can separate melanomas from harmless skin lesions on the basis of 23 genes. Called myPath Melanoma, the test was run on 450 skin biopsies and was more than 90% accurate, according to results reported at the 2013 meeting of the American Society of Dermatopathology. On the strength of these results, the $1,500 test is now being piloted by selected dermatopathologists.
The same imaging technology used at airport security checkpoints could also help us find melanomas that we can’t see yet, according to research presented at the American Chemical Society’s fall 2013 meeting. The technology uses terahertz rays (T-rays), which are the wavelengths between microwaves and the infrared rays that we feel as heat. In contrast to X-rays, T-rays are not ionizing and so are much safer, penetrating only a few millimeters into the skin. Melanomas start in the deepest part of the skin’s outer layer, long before they appear on the surface as mole-like growths. Early results suggest that dermatologists could use T-rays to diagnose melanomas that are just beginning to form.
Many dermatologists worry about missing melanomas, and in 2011 the FDA approved a tool that could help them catch more of these aggressive skin cancers. But the word is still out on whether it works. Called MelaFind, the device can ‘see’ 2.5 mm deep into the skin, makes images of different layers, and uses pattern-recognition algorithms to assess the likelihood of melanoma. Drawbacks include that MelaFind can only be used on small pigmented spots and that it gives a lot of false positives, which could lead to unnecessary biopsies. But dermatologists who use this tool say that they use their own judgment to make the final call and that MelaFind makes them more confident in their diagnoses.