Clinical correlates of Breslow thickness of malignant melanoma

Abstract

Results were similar for the two thickness groups, but more significant for the thick group. The previously described correlations of tumour thickness and increasing age (P < 0.00001) and location on head and neck (P = 0.0002), together with the independence of these variables, have been confirmed. The correlation with male gender was also confirmed but this was weak (P = 0.05). Novel findings were correlations of Breslow thickness with all features of the seven-point checklist (P varying from P = 0.01 to P < 0.00001) and tumour elevation (P < 0.00001). In general in the seven-point checklist, the absence of the major features (except variation in size) (P < 0.00001) and presence of minor features (except altered sensation) (P varying from P = 0.004 to P < 0.00001) were strongly associated with thick MMs. These results for tumour thickness are a further argument for retention of the minor features of the seven-point checklist. False negative diagnosis was found to be correlated with tumour thickness (P < 0.02) but this relationship was lost on multivariate analysis with inclusion of the clinical features. MM thickness was highly correlated with primary referral clinic (P < 0.00001). Only approximately 8% of MMs presenting to the Pigmented Lesion Clinic (PLC) were thick, while the proportion presenting to general dermatology was about three times greater and to plastic surgery about five times greater. This was maintained on multivariate analysis, including all other variables and, therefore, there must be other determining factors of referral not examined in the study. Conclusion MM thickness is associated with increasing age, male gender, location on the head and neck, all features of the seven-point checklist, tumour elevation and referral to the PLC. It is important to investigate further the reasons for general practitioner referral of different thickness MM to different types of clinic, as referral to clinics other than the PLC results in delay in the first hospital appointment, and it is now apparent that thicker lesions are disproportionately affected.

Mitochondrial Haplogroups, Control Region Polymorphisms and Malignant Melanoma: A Study in Middle European Caucasians

“…Several studies showed that Breslow thickness is associated with male gender [30], [31]. This finding was confirmed by our study.…”

Association Between Mohs Surgery Wait Times and Surgical Defect Size in Patients With Squamous Cell or Basal Cell Carcinoma of the Skin

“…Although research has been performed investigating the relationship between surgical delay and tumor growth in melanoma patients, [23][24][25][26][27] few studies have looked at this same effect for the treatment of NMSC. Kirkup and De Berker examined 50 patients with BCC of the face, but outside the "central T" (nose and periorbital areas, including eyebrows and glabella), and compared major and minor diameters at presentation and again on the day of surgery.…”

A novel polymorphism in the 1A promoter region of the vitamin D receptor is associated with altered susceptibilty and prognosis in malignant melanoma

“…On the basis of Breslow thickness, patients were divided into five conventional Breslow thickness groups (0 -4); in situ, o0.75 mm, 0.75 -1.49 mm, 1.5 -3.49 mm and X3.5 mm (Mackie et al, 1985). For the occurrence studies, a subsample of patients were stratified according to Breslow thickness group to conform with frequencies within groups according to the reported distribution in the Leicestershire area (n ¼ 738) (Osborne and Hutchinson, 2001). Controls consisted of UK Caucasian patients not known to have cancer.…”