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A resection margin or surgical margin is the margin of apparently non-tumorous tissue around a tumor that has been surgically removed, called "resected", in surgical oncology. The resection is an attempt to remove a cancer tumor so that no portion of the malignant growth extends past the edges or margin of the removed tumor and surrounding tissue.
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.
A small scalpel is utilized to cut around the visible tumor. Unlike a normal surgical excision, a Mohs surgery cut is performed at a beveling between 10 and 45 degrees to allow visibility of all skin layers during pathological diagnosis. [8] A very small surgical margin is utilized, usually with 1 to 1.5 mm of "free margin" or uninvolved skin.
Surgical excision with a large safety margin is the main treatment for localized amelanotic melanoma. 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 ...
The wide excision aims to reduce the rate of tumor recurrence at the site of the original lesion. This is a common pattern of treatment failure in melanoma. Considerable research has aimed to elucidate appropriate margins for excision with a general trend toward less aggressive treatment during the last decades. [107]
In histopathology, radicality of tumor excisions is generally defined as the absence of tumor cells in a certain resection margin, with the specific margin width varying by tumor type and local guidelines. [3] A non-radical excision may require re-excision. [clarification needed]
Atypical mole removal is performed when moles look dysplastic, as this is associated with an increased risk of melanoma; Cosmetic mole removal is performed when moles are non-cancerous, but are preferred to be eliminated due to aesthetic or practical considerations. [25] Shave excision is the most frequently used method for mole removal.