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Outcomes of Transected Melanoma Diagnosed by Shave Biopsy: A Single-Institution Retrospective Analysis
David Griffin1,2, Erik J Stratman1
1Department of Dermatology, Marshfield Clinic Health System, Marshfield, Wisconsin.
Background:
In the histologic analysis of melanoma, Breslow depth is a critical component of prognostication. Transecting the tumor through tangential biopsy technique potentially affects staging, treatment, and outcomes.
Objective:
Compare outcomes of transected and nontransected melanomas biopsied by tangential biopsy technique.
Patients And Methods:
This is a single-center retrospective cohort study. Patients were matched based on American Joint Commission on Cancer eighth edition Tumor (T) stage and tumor transection status.
Results:
Patients with transected melanomas experienced significant increases in 5-year recurrence ( p = .023), 5-year mortality ( p = .004), metastasis ( p = .035), and melanoma-related mortality ( p = .002). However, after stratifying by T stage, there were no significant differences in recurrence, metastasis, or mortality between transected and nontransected tumors. Transected tumors <1.0 mm had a higher rate of sentinel lymph node biopsies (SNLB) performed compared with the nontransected tumors <1.0 mm. Limitations include population size, single-institution retrospective nature of the study, and homogenous population.
Conclusion:
While there were no significant differences in patient outcomes by T stage when melanomas were transected by shave biopsy, shallow (<1.0 mm) transected melanomas were more likely to receive sentinel lymph node biopsy compared with nontransected melanomas. Biopsy technique should aim to a depth that provides the full Breslow depth of melanoma tumors.
