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A large study validated the importance of tumor depth (but not Breslow's original description) as one of the three most important prognostic factors in melanoma (the others being T stage and ulceration). [4] Breslow's depth also accurately predicted the risk for lymph node metastasis, with deeper tumors being more likely to involve the nodes. [5]
The concept of the sentinel lymph node is important because of the advent of the sentinel lymph node biopsy technique, also known as a sentinel node procedure. This technique is used in the staging of certain types of cancer to see if they have spread to any lymph nodes, since lymph node metastasis is one of the most important prognostic signs .
Neither sentinel lymph node biopsy nor other diagnostic tests should be performed to evaluate early, thin melanoma, including melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm. [114] People with these conditions are unlikely to have the cancer spread to their lymph nodes or anywhere else and have a 5-year survival rate of 97%. [ 114 ]
Treatment is by excisional biopsy, wide local excision and possibly sentinel node biopsy. Localized melanoma, which has not spread beyond the skin, has a very good prognosis with low recurrence rates. Spread of disease to local lymph nodes or distant sites (typically brain, bone, skin and lung) marks a decidedly poor prognosis.
The site began in 1998 as a pen and paper questionnaire called the Harvard Cancer Risk Index. [2] In January 2000, The Harvard Cancer Risk Index developed into an online assessment and was renamed Your Cancer Risk, and offered assessments for four cancers: breast, colon, lung, and prostate. Six months later, eight additional cancers were added. [3]
Vulvar melanomas are unique in that they are staged using the AJCC cancer staging for melanoma instead of the FIGO staging system. [29] Diagnosis of vulvar melanoma is often delayed and approximately 32% of women already have regional lymph node involvement or distant metastases at the time of diagnosis.
Generally speaking, it is associated with lymph node metastases [2] [3] which themselves are predictive of a poorer prognosis. [4] In the context of ( histologically ) proven lymph node metastases, LVI may have less prognostic significance or no prognostic significance.
Cancer slope factors (CSF) are used to estimate the risk of cancer associated with exposure to a carcinogenic or potentially carcinogenic substance. A slope factor is an upper bound, approximating a 95% confidence limit, on the increased cancer risk from a lifetime exposure to an agent by ingestion or inhalation.