The evidence on incisional biopsy in MM remains controversial but the balance of observational evidence suggests that it is unlikely to influence prognosis adversely. Large studies have shown that, in general, incisional biopsies do not affect prognosis, except for the single study of melanoma of the head and neck, where there was a significant worsening in the survival of patients who underwent an incisional biopsy compared with those who had their lesions excised initially.14 This study was, however, retrospective and no adjustment was made for ulceration of the tumours, which is known to worsen prognosis. Any future study should be prospective and the design of the study should ensure that study groups are randomised to balance for the various factors that may influence prognosis.
What are the surgical recommendations for excision margins for different Breslow thickness tumours?
The Breslow thickness represents the depth of invasion of cutaneous melanoma and is measured histologically from the granular layer to the deepest melanoma cells. It is the single best indicator of prognosis in primary cutaneous MM.6 All of the trials so far performed in patients with MM have used the Breslow thickness of the tumour to categorise different patient groups. As a result of these trials, surgical margins of excision of MM have decreased significantly over the past 20 years.
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Complete Guide to Preventing Skin Cancer. We all know enough to fear the name, just as we do the words tumor and malignant. But apart from that, most of us know very little at all about cancer, especially skin cancer in itself. If I were to ask you to tell me about skin cancer right now, what would you say? Apart from the fact that its a cancer on the skin, that is.