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PubMed · 8272906

Think melanoma.

Abstract

Every physician's office should be a melanoma detection station. Identification and surgical excision of early melanoma is today's best answer to reducing the death rate from this treacherous disease. Public awareness of melanoma is gaining momentum. Melanoma education for physicians is vital if the battle against melanoma is to be successful. This presentation is a challenge to all physicians and students of medicine to identify patients at risk for melanoma and to follow up with a skin scan to search for suspicious spots on all patients with risk factors for melanoma as a part of their physical examination. We need to teach individuals at risk to do self-examination, to report immediately any recent growth changes in an existing mole or any recently acquired pigmented lesion, and to practice the rules of safe sun exposure. Because securing a suitable specimen of tissue for biopsy and proper interpretation of sections are paramount in patient management and understanding prognosis, we present guidelines for performing a proper biopsy.

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BibTeXRIS

C J Cockerell, J B Howell, C M Balch. 1993. Think melanoma.. https://doi.org/10.1097/00007611-199312000-00001

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Non-radical diagnostic biopsies do not negatively influence melanoma patient survival.

BACKGROUND: In fair-skinned Caucasian populations both the incidence and mortality rates of cutaneous melanoma have been increasing over the past decades. With adjuvant therapies still being under investigation, early detection is the only way to improve melanoma patient survival. The influence of incisional biopsies on melanoma patient survival has been discussed for many years. This study investigates both the influence of diagnostic biopsy type and the presence of residual tumor cells in the re-excision specimen on disease free and overall survival. METHODS: After (partial) removal of a pigmented skin lesion 471 patients were diagnosed with stage I/II melanoma and underwent re-excision and a sentinel node biopsy. All patients were followed prospectively, mean follow up >5 years. Patients were divided according to their diagnostic biopsy type (wide excision biopsy, narrow excision biopsy, excision biopsy with positive margins and incisional biopsy) and the presence of residual tumor cells in their re-excision specimen. Survival analysis was done using Cox's proportional hazard model adjusted for eight important confounders of melanoma patient survival. RESULTS: The diagnostic biopsy was wide in 279 patients, narrow in 109 patients, 52 patients underwent an excision biopsy with positive margins and 31 patients an incisional biopsy. In 41 patients residual tumor cells were present in the re-excision specimen. Both the diagnostic biopsy type and the presence of tumor cells in the re-excision specimen did not influence disease free and overall survival of melanoma patients. CONCLUSIONS: Non-radical diagnostic biopsies do not negatively influence melanoma patient survival.

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