Does a dermatologist's diagnosis of a neoplasm (new, uncontrolled growth) of uncertain behavior in a removed mole necessarily indicate cancer?

From the Guidelines

A diagnosis of "neoplasm of uncertain behavior" does not necessarily mean cancer, and it's a precautionary measure to determine the nature of the mole through biopsy. This medical term simply indicates that the dermatologist cannot determine whether the mole is benign or malignant just by looking at it, which is why they removed it for biopsy, as suggested by the European Society for Medical Oncology (ESMO) clinical practice guidelines for diagnosis, treatment, and follow-up of cutaneous melanoma 1. The biopsy will allow pathologists to examine the cells under a microscope to determine the exact nature of the mole, following the American Joint Committee on Cancer (AJCC) classification, which includes information on the maximum thickness, mitotic rate, presence of ulceration, and clearance of surgical margins 1. Many moles that are biopsied turn out to be completely benign. Some key points to consider include:

• The "ABCD rule" for suspicious lesions, which includes Asymmetry, Border irregularities, Color heterogeneity, and Dynamics (Dynamics or evolution in colors, elevation or size) 1
• The importance of dermoscopy by an experienced physician to enhance diagnostic accuracy 1
• The need for a full-thickness excisional biopsy with a small side margin and processing by an experienced pathology institute 1 Your dermatologist is being thorough by removing the mole for further testing rather than making assumptions about its nature. The term "uncertain behavior" is a classification used when the growth's potential cannot be determined visually, and it's best to wait for the biopsy results before drawing any conclusions. Your doctor will contact you with the results once they're available, typically within 1-2 weeks.

From the Research

Understanding the Diagnosis

• The term "Neoplasm of uncertain behavior" refers to a growth or tumor that cannot be definitively classified as benign or malignant based on its appearance or initial examination [ 2 ].
• This diagnosis does not necessarily mean cancer, but it indicates that the mole's behavior is uncertain and requires further examination.

Biopsy and Diagnosis

• A biopsy is a procedure where a sample of tissue is removed from the body for examination under a microscope [ 2 ].
• The goal of a biopsy is to determine the nature of the tissue, whether it is benign, malignant, or of uncertain behavior.
• In the case of a mole, a biopsy can help determine if it is a melanoma, a type of skin cancer, or a non-cancerous growth.

Treatment Options

• Treatment options for skin cancers, including melanoma, can include surgical removal, topical treatments, and immunotherapy [ 3, 4,5 ].
• The choice of treatment depends on the type and stage of the cancer, as well as the patient's overall health.

Importance of Further Examination

• The diagnosis of "Neoplasm of uncertain behavior" highlights the importance of further examination and testing to determine the nature of the mole [ 6 ].
• This may involve additional biopsies, imaging tests, or other diagnostic procedures to gather more information about the mole and develop an appropriate treatment plan.