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In medicine, Breslow's depth was used as a prognostic factor in melanoma of the skin. It is a description of how deeply tumor cells have invaded. Currently, the standard Breslow's depth has been replaced by the AJCC depth, in the AJCC staging system of melanoma. Originally, Breslow's depth was divided into 5 stages. [1]
Complete circumferential peripheral and deep margin assessment (CCPDMA) is the preferred method for the removal of certain cancers, especially skin cancers. [ 1 ] [ 2 ] There are two forms of CCPDMA surgery: Mohs surgery and surgical excision coupled with margin assessment.
Many surgeons consider 0.5 cm (0.2 in) the standard of care for standard excision of melanoma-in-situ, [106] but 0.2 cm (0.1 in) margin might be acceptable for margin controlled surgery (Mohs surgery, or the double-bladed technique with margin control). The wide excision aims to reduce the rate of tumor recurrence at the site of the original ...
Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment - CCPDMA) using frozen section histology. [1] CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
Clark's level is a staging system, which describes the level of anatomical invasion of the melanoma in the skin. It was developed by Wallace H. Clark Jr. at Harvard University and Massachusetts General Hospital in the 1960s.
The suggested margin size for amelanotic melanoma is debatable since it varies according to the lesion's development, thickness, and invasion depth. [34] Guidelines from the Annals of Surgery, however, suggest that melanomas larger than 2 mm be removed with 2 cm margins.
This excisional biopsy is often done with a narrow surgical margin to make sure the deepest thickness of the melanoma is given before prognosis is decided. However, as many melanoma-in-situs are large and on the face, a physician will often choose to do multiple small punch biopsies before committing to a large excision for diagnostic purpose ...
Once this confirmatory biopsy is done, a second complete excisional skin biopsy can be performed with a narrow surgical margin (1 mm). This second biopsy will determine the depth and invasiveness of the melanoma, [20] and will help to guide further treatment if necessary.