Invasive behavior of small diameter melanomas

Dermoscopic features and screening strategies for the detection of small‐diameter melanomas

“…Small‐diameter MMs (≤ 5 mm) accounted for a significant proportion (27.6%) of the MMs diagnosed in our cohort, which is in accordance with rates reported previously (2.4%–38.2%) 2–10 . Nevertheless, the lack of consensus to define ‘small’ impairs the accurate comparison of different studies, with cutoff diameter varying from ≤ 6 mm to ≤ 3 mm 3–13,22 …”

“…Tiny MMs frequently show a vertical growth phase and have similar prognosis to invasive nontiny lesions, with similar prognostic attributes. 7 Although invasive, most small-diameter MMs we detected were early Stage 1 (T1a), with less impact on morbidity, mortality and healthcare costs. However, it is notable that median Breslow thickness was not deeper for lesions of larger diameter, even when only invasive MMs were considered, contrary to what would be intuitively expected.…”

“…[2][3][4][5][6][7][8][9][10] Nevertheless, the lack of consensus to define 'small' impairs the accurate comparison of different studies, with cutoff diameter varying from ≤ 6 mm to ≤ 3 mm. [3][4][5][6][7][8][9][10][11][12][13]22 The proportion of small MMs may also have been overestimated in some case series by lesion measurement after histopathological processing, without considering the ex vivo tissue shrinkage of approximately 20%. 11,23 In vivo measurement, ideally guided by dermoscopy, is the most reliable method, as it includes peripheral areas not necessarily visible to the naked eye.…”

“…Given that approximately 70% of cutaneous malignant melanomas (MMs) develop de novo, 1 smalldiameter or tiny lesions are expected to represent the earliest clinical manifestation of most MMs. 2 The proportion of MMs excised when still small varies considerably in the literature, ranging from 2.4% to 38.2%, [2][3][4][5][6][7][8][9][10][11] depending on the measurement method and diameter cutoff used to define 'small'. Although previous studies have shown a positive correlation between diameter and tumour thickness, 3 there is growing evidence demonstrating that small does not mean in situ, with up to 70% of these lesions reported as being invasive.…”

Dermoscopy features of melanomas with a diameter up to 5 mm (micromelanomas): A retrospective study

“…Although previous studies have shown significant positive correlation between Breslow thickness and melanoma diameter, our results underline that small size does not exclude invasion. 5 Limitations of the current study include small sample size, retrospective design, and lack of controls. The utility of our findings for the differential diagnosis among lesions less than 5 mm diameter and different skin phenotypes requires further investigation.…”