Factors Influencing the Use of Shave Biopsy for Lesions Suspicious of Melanoma in Australia: An Exploratory Mixed-Methods Study
- PMID: 39800855
- DOI: 10.1111/ajd.14411
Factors Influencing the Use of Shave Biopsy for Lesions Suspicious of Melanoma in Australia: An Exploratory Mixed-Methods Study
Abstract
Background: Recent Australian trends indicate that shave biopsies for diagnosing lesions suspicious of melanoma are increasing, yet reasons for this remain relatively unknown. We sought to understand which factors influence Australian clinicians' use of shave biopsy for managing thin lesions suspicious of melanoma in sites of low cosmetic sensitivity.
Methods: We used a convergent, exploratory mixed-methods design, with a cross-sectional online survey (n = 59) and semi-structured qualitative interviews (n = 15). We recruited clinicians working in skin cancer medicine across Australia, mostly general practitioners (> 80%) with some dermatologists (n = 7 survey and n = 1 interview participant). Survey participants indicated how frequently they used shave biopsies and rated the importance of factors when considering the use of a shave biopsy. Interview participants elaborated on the motivating factors for using different biopsy techniques. Qualitative data were professionally transcribed and analysed with content analysis.
Results: Most survey participants (95%) reported that identifying fewer signs of locally advanced melanoma was 'very important' for using shave biopsy. Fifty per cent of survey participants also reported that faster procedure speed and greater convenience were 'very important' reasons for using shave biopsy. Procedure speed was particularly important for using shave biopsy among clinicians self-identifying as time-poor. Interview participants noted (a) the risk of transecting the lesion base or (b) incomplete lesion removal from shave biopsies as reasons against their use.
Conclusions: The relative speed and convenience of shave biopsies in clinical practice are strong motivators for their use. Further evidence on patient outcomes with widespread use of shave biopsy is required to inform clinical guidelines.
Keywords: biopsy; dermatology; general practice; melanoma; skin neoplasms.
© 2025 Australasian College of Dermatologists.
Similar articles
-
Choosing to biopsy or refer suspicious melanocytic lesions in general practice.BMC Fam Pract. 2012 Aug 8;13:78. doi: 10.1186/1471-2296-13-78. BMC Fam Pract. 2012. PMID: 22873705 Free PMC article.
-
The increasing use of shave biopsy for diagnosing invasive melanoma in Australia.Med J Aust. 2019 Sep;211(5):213-218. doi: 10.5694/mja2.50289. Epub 2019 Jul 22. Med J Aust. 2019. PMID: 31328802
-
A comparison of current practice patterns of US dermatologists versus published guidelines for the biopsy, initial management, and follow up of patients with primary cutaneous melanoma.J Am Acad Dermatol. 2016 Dec;75(6):1193-1197.e1. doi: 10.1016/j.jaad.2016.07.051. Epub 2016 Oct 11. J Am Acad Dermatol. 2016. PMID: 27742167
-
A comparison of dermatologists' and primary care physicians' accuracy in diagnosing melanoma: a systematic review.Arch Dermatol. 2001 Dec;137(12):1627-34. doi: 10.1001/archderm.137.12.1627. Arch Dermatol. 2001. PMID: 11735713
-
Role of In Vivo Reflectance Confocal Microscopy in the Analysis of Melanocytic Lesions.Acta Dermatovenerol Croat. 2018 Apr;26(1):64-67. Acta Dermatovenerol Croat. 2018. PMID: 29782304 Review.
References
-
- J. Kelly, T. Beer, D. Damian, et al., “Clinical Practice Guidelines for the Diagnosis and Management of Melanoma (Features of Melanoma, Biopsy, Sentinel Node Biopsy, Excision Margins) Cancer Guidelines Wiki: Cancer Council Australia,” 2016, accessed June 25, 2024, http://wiki.cancer.org.au/australia/Guidelines:Melanoma/Foreword.
-
- V. J. Mar, H. Soyer, A. Button‐Sloan, et al., “Diagnosis and Management of Cutaneous Melanoma,” Australian Journal of General Practice 49, no. 11 (2020): 733–739.
-
- G. G. Matheus and J. Muir, “Shave Procedures in the Management of Skin Lesions Where Melanoma Is a Differential Diagnosis,” Australian Journal of General Practice 53, no. 8 (2024): 533–536.
-
- S. M. Swetter, H. Tsao, C. K. Bichakjian, et al., “Guidelines of Care for the Management of Primary Cutaneous Melanoma,” Journal of the American Academy of Dermatology 80 (2019): 208–250.
-
- C. So, D. McCarthy, C. G. Watts, et al., “Diagnostic Biopsies of Suspected Skin Cancer in General Practice From 2010 to 2017 in Victoria, Australia,” British Journal of Dermatology 188, no. 4 (2023): 560–561.
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical