Detection of mitotic figures in thin melanomas—Immunohistochemistry does not replace the careful search for mitotic figures in hematoxylin-eosin stain

iDermatoPath – a novel software tool for mitosis detection in H&E‐stained tissue sections of malignant melanoma

“…described double staining with a melanocytic marker and a mitosis marker as a useful tool. On the other hand, evaluation of H&E slides remains very important as recently shown by Ottman et al …”

“…Therefore, Ilkenberg et al 23 described double staining with a melanocytic marker and a mitosis marker as a useful tool. On the other hand, evaluation of H&E slides remains very important as recently shown by Ottman et al 24 Certainly, it would be very helpful to develop a (computer) device, with which the accuracy in dermatopathological diagnostic is reliably increased. It is without question that human inspection and evaluation by experienced dermatopathologists cannot be completely replaced by a computer-based method.…”

Sentinel node metastasis mitotic rate (SN‐MMR) as a prognostic indicator of rapidly progressing disease in patients with sentinel node‐positive melanomas

“…Despite its inclusion into the AJCC 2009 classification as a decisive parameter, there is an ongoing debate about the feasibility and reproducibility of MR determination in thin primary melanomas. Two studies found good to excellent interobserver reproducibility when analyzing pT1 melanomas and primary melanomas of all stages (pT1–pT4), while a recent study found unsatisfactory inter‐ and intraobserver reproducibility when looking at pT1 and pT2 melanomas . Similarly, the general prognostic value of the MR in primary melanomas has been demonstrated in several studies, while others were unable to provide statistical evidence that a MR >0 in a thin primary melanoma is significantly correlated with an increased risk of a positive SN …”

“…anti‐phosphohistone H3) and melanocytes could be implemented to potentially improve accuracy and speed of the SN‐MMR measurement. However, it is known that the MR of primary melanomas assessed by IHC is approximately twofold higher than the MR assessed by H&E staining and another study showed that the implementation of the same IHC could not replace assessment by H&E and was not time‐efficient . Therefore, additional studies would be necessary to clarify the feasibility and prognostic value of a SN‐MMR classification assessed by double staining on IHC in comparison to H&E staining.…”

“…However, it is known that the MR of primary melanomas assessed by IHC is approximately twofold higher than the MR assessed by H&E staining 31 and another study showed that the implementation of the same IHC could not replace assessment by H&E and was not time-efficient. 21 Therefore,…”