MONDAY, July 1, 2019 (HealthDay News) -- Stratification of melanoma into groups based on calculated tumor area improves prognostic value over stratification using the category based on Breslow thickness
, according to a study published online June 26 in JAMA Dermatology.
Patients assessed in the expanded cohort had a median age of 60 years and a median Breslow thickness
of 1.4 mm.
Key points for dermatologists to understand include that reporting of Breslow thickness
should be to the nearest 1 / 10th decimal point (over the nearest 1 / 100th), such that a melanoma measuring 0.75-0.84 mm in thickness would be reported as 0.8-mm depth and one between 0.95-1.04 mm would be rounded to 1 mm.
The poor prognosis associated with AM is generally attributed to late diagnosis and relatively higher Breslow thickness
, but also to an intrinsic biological aggressiveness.
Five of 17 malignant melanoma patients had a lesion with Breslow thickness
<1 mm with a negative sentinel lymph node.
The Breslow thickness
of the detected lesions varied between 0.6-17.0 mm.
This includes patients who have a clinical stage IA/T1a melanoma with a Breslow thickness
of less than 0.8 mm without ulceration.
The extracted data from the eligible trials included first author's name, study type, trial location and year, sample size, age and gender of the patients, duration of follow-up, MVD assessment method, cut-off value for MVD, categorization of tumor based on Clark's level and Breslow thickness
, location and histotype of melanoma, and information regarding the treatment applied.
A primary BRAFF600E positive 0.9 mm Breslow thickness
superficial spreading malignant melanoma was treated with wide local excision the previous year, which recurred within five months and he was found to have in-transit metastasis with left axillary palpable lymphadenopathy.
More specifically, there was a malignant melanocytic lesion mainly in horizontal growth phase with focal vertical growth, which infiltrated the papillary dermis, while Breslow thickness
was estimated at 0.45 mm and evaluated as Clark's level III (Figures 1(c) and 1(d)).