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Biopsy Techniques for Melanoma 

Biopsy Techniques for Melanoma
Chapter:
Biopsy Techniques for Melanoma
Author(s):

Maki Yamamoto

and Jonathan S. Zager

DOI:
10.1093/med/9780199971015.003.0003
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date: 19 September 2019

In 2014, the incidence of cutaneous melanoma in the United States was 76,100, making it the fifth most common malignancy in males and seventh amongst females. Early diagnosis has clear implications for overall survival and depends on the liberal use of biopsies of suspicious cutaneous lesions. Proper surgical treatment of the primary tumor (determination of margins of excision) and the decision whether to surgically evaluate the regional nodal basin when it is clinically negative (by sentinel lymph node biopsy) both rely on precise preoperative assessment of primary tumor pathological factors. Accurate measurement of the Breslow thickness, as well as assessment for the presence of ulceration, mitotic rate (especially in thin ≤1 mm melanomas), amongst other primary tumor factors (lymphovascular invasion, satellitosis, regression, Clark’s level), all play a role in the surgical decision-making process. Debate continues regarding the optimal biopsy technique for the diagnosis and initial microstaging of melanoma.

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