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In recognition of his contribution, the depth of invasion of melanoma is referred to by the eponym Breslow's depth. Subsequent studies confirmed and refined the role of depth of invasion in the prognosis of malignant melanoma. [2] [3] Currently, Breslow's depth is included in the AJCC staging guidelines for melanoma as a major prognostic factor.
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.
The prognosis of acral lentiginous melanoma is based on multiple factors including gender, age, race, Breslow depth, staging, and sentinel lymph node positivity. [7] Out of these factors, it is believed that sentinel lymph node positivity provides the strongest prediction of cancer recurrence and death.
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 ...
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.
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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.
Evolution of a 4 mm nodular melanoma. Nodular melanoma (NM) is the most aggressive form of melanoma. [1] It tends to grow more rapidly in thickness (vertically penetrate the skin) than in diameter compared to other melanoma subtypes. [2] Instead of arising from a pre-existing mole, it may appear in a spot where a lesion did not previously exist.