Melanoma Flashcards
What determines the excision margin of a wide local excision for a melanoma?
The Breslow thickness
How do you assess a mole?
A - Asymmetry
B - Boarder
C - Colour
D - Diameter >6mm
E - Elevated
F - Firm
G - Growing
Assess for local spread
What are some risk factors for melanoma?
UV exposure
Previous melanomas
Many moles
Complexion - fair skin and hair
Immunosuppression
Sun beds
FHx
Outline the Breslow classification system and how the categories dictate excisional margins
In situ - 5mm
<1mm - 1cm
1-4mm - 1-2cm
>4mm - 2cm
How are melanomas removed?
Wide local excision
How are melanomas classified?
Superficial spreading melanoma (80%)
Nodular melanoma
Lentigo maligna melanoma
Acral lentiginous melanoma
In which age group is melanoma most common?
15-44
4th Most common cancer in Australia in males and females
When is sentinel LN biopsy indicated?
>1mm thick
How do you biopsy a mole?
Biopsy with 2mm margin
Orientation the excision along the long axis on extremities or along the lines of relaxed skin tension
What are some prognostic factors for melanoma?
Regional spread
Breslow’s thickness
Clark’s level
Ulceration
Mitotic count (no. mitosis per mm2)
Anatomical site
Age/Sex
What is neurotropism?
Travel along the nerve
How is T in TNM staging determined?
Depth
+/- Ulceration
Where do you commonly find melanomas in males and females?
Males - Trunk, head and neck
Females - Legs
What are some symptoms of melanoma?
Change in size, colour, shape or border
Pain
Itch
Bleeding
What is the challenged with nodular melanoma?
Rapidly growing
Invade early
Majority are amelanotic
