The rate of melanoma transection with various biopsy techniques and the influence of tumor transection on patient survival.

This is interesting. Survival does not change due to biopsy technique (but there does seem to be a trend). But I wonder how many melanoma diagnoses are missed due to sub-optimal biopsy technique?




J Am Acad Dermatol. 2012 Sep 8. [Epub ahead of print]

The rate of melanoma transection with various biopsy techniques and the influence of tumor transection on patient survival.


Baylor College of Medicine, Houston, Texas.



Depth of melanoma invasion is critical because it dictates patient treatment and prognosis. Recent reports indicate melanoma transection with initial biopsy does not impact patient survival; however, tumor transection can lead to misdiagnosis and inaccurate staging.


This study assessed the rate of melanoma transection with various biopsy techniques and the impact of tumor transection on patient survival.


We conducted a retrospective review of all melanoma cases at our institution between 2000 and 2008. Of the 490 melanoma cases identified, 479 met inclusion criteria for the study. The transection rates of biopsy techniques were determined. Cases of transected tumors were matched with nontransected cases in a retrospective case-control fashion to evaluate survival.


The rate of melanoma transection was 1.5% for excisional biopsies, 4.1% for punch biopsies, and 9.0% for saucerization biopsies. The means of disease-free survival for the control and transected groups were 911 days and 832.7 days, respectively (P value .67). Overall survival for the control group was 1073.7 days versus 1012.4 days for the transected group (P value .72).


The study used a select population. The sample size of transected biopsies was limited, in turn limiting the power of the study. Residents performed the majority of biopsies.


Punch and saucerization biopsies were more likely to transect tumors than excisional biopsies. The transection of melanoma did not affect overall disease-free survival or mortality in the population studied.

Risk of melanoma with other cancers

Hi All

Happy new year

I found this interesting



Cutaneous Melanoma Risk Higher Among Cancer Survivors
A study published in the December issue of the Archives of Dermatology, one of theJAMA/Archives journals reveals that, cancersurvivors have a higher chance of developing cutaneous melanoma (CM), one of the most aggressive forms of skin cancer. Individuals with previously diagnosed melanoma are at the highest risk.

In the United States, CM is the fifth most commonly diagnosed cancer among men and the seventh among women. The number of CM cases is rising, while mortality rates from the disease have not considerably decreased. UV radiation exposure is the greatest risk factor for the development of CM, although this risk is affected by individuals’ genetics and race.

In order to understand the risk of CM in cancer survivors, Geoffrey B. Yang, B.S., a medical student at Case Western Reserve School of Medicine, Cleveland, Ohio, and his team examined data from the Surveillance, Epidemiology, and End Results database from 1988 to 2007. 70,819 individuals diagnosed with CM as a first primary cancer (median age of 54 years at the time of diagnosis) were included in the investigation, as well as 6,353 cancer survivors with CM (median age 70 years at time of melanoma diagnosis).

The researchers discovered that individuals with a previous melanoma diagnosis were at higher risk of developing melanoma – a discovery consistent with other investigations. Among individuals under 45 years at initial cancer diagnosis, 777 developed cutaneous melanoma.

The risk of developing CM was considerably higher among patients with previous CM, other skin cancer, Kaposi sarcomalymphoma and female breast cancer. Individuals aged 45+ at initial cancer diagnosis had a considerably higher risk of developing CM following first CM diagnosis, other skin cancers, female breast cancer, lymphoma, leukemiaocular melanoma, and prostate cancer.

The researchers explain:
“Characteristics associated with better survival in both cohorts included female sex, age younger than 45 years at melanoma diagnosis, being married, being white vs. black, decreasing Breslow depth [how deeply tumor cells have invaded], lack of tumor ulceration, no nodal involvement, and absence of metastases [the spread of cancer from the primary tumor to other locations in the body.”

They conclude:
“Given that cutaneous melanoma is the most common second primary cancer in patients with first CM (a risk that remains elevated for over 15 years), our results suggest the need for continued skin surveillance in melanoma survivors.”