Surgical management of stage I malignant melanoma

In part because of the increased public awareness regarding skin cancer, patients are presenting to their physician with thinner melanomas. Many lesions are now found in the in situ phase. The vast majority of melanomas referred to or diagnosed in the Skin Oncology Program at Boston University are less than 2 mm in thickness. In the increasingly uncommon situation of thicker lesions, the standard 3-cm margin excision continues to be performed until clinical trials indicate that lesser margins are safe. Definitive surgery is only part of the physician's responsibility in caring for the patient with melanoma. These patients need to be followed up on a regular basis for life, because of the long latent period for risk of metastasis and to facilitate early detection of new primary melanomas.