A 35 year old premenopausal patients as recently developed a 1.5 cm sized pigmented lesion on her back. Which of the following forms of tissue diagnosis will you recommend for her?

It may be malignant melanoma so investigations are done to confirm the diagnosis MANAGEMENT History and clinical examination should be directed at discovering the primary lesion and identification of local, regional or distant spread. An excision biopsy with 2-3 mm margin of skin and a cuff of subdermal fat is acceptable. Incision biopsy is occasionally Indicated: for instance, in large lesions on the face where an excision biopsy of the whole lesion would be disfiguring. In experienced hands, observation and review every 2 months may avoid biopsies in equivocal cases, but serial clinical and dermoscopic photography by a clinician with expeise in dermoscopy is mandatory when observation is chosen, rather than excision biopsy, for definitive histopathological diagnosis. Biopsy and pathological examination provide the first step towards staging melanoma. The Breslow thickness of a melanoma (measured to nearest 0.1 mm from granular layer to base of tumour) is the most impoant prognostic indicator in the absence of lymph node metastases. The American Joint Committee on Cancer (AJCC) staging system then takes lymph node and distant metastases into account Ref: Bailey and love 27th edition Pgno : 611