Is incisional biopsy of melanoma harmful?
- PMID: 16307945
- DOI: 10.1016/j.amjsurg.2005.08.020
Is incisional biopsy of melanoma harmful?
Abstract
Background: In the era of sentinel lymph node (SLN) biopsy, there has been concern that manipulation, injection, and massage of intact primary melanomas (after incisional or shave biopsy) could lead to an artifactual increased rate of SLN micrometastases or an actual increased risk of recurrence. The aim of this study was to evaluate the difference in the incidence of SLN metastasis, locoregional recurrence (LRR), disease-free survival (DFS), distant disease-free survival (DDFS), or overall survival (OS) for patients who undergo excisional versus incisional versus shave biopsy.
Methods: Analysis of database from a multicenter prospective randomized study from centers across the United States and Canada. Eligible patients were 18 to 71 years old, with cutaneous melanoma > or = 1.0 mm Breslow thickness. All patients underwent SLN biopsy using blue dye and radioactive colloid injection. SLNd were evaluated by serial histological sections with S100 immunohistochemistry. Statistical analysis was performed using univariate and multivariate analyses with a significance level of P < .05; survival analysis was performed by the Kaplan-Meier method with the log-rank test.
Results: A total of 2,164 patients were evaluated; 382 patients were excluded for lack of biopsy information. Positive SLNs were found in 220 of 1,130 (19.5%), 58 of 281 (20.6%), and 67 of 354 (18.9%) of patients with excisional, incisional, or shave biopsy, respectively (no significant difference). There were significant differences among the 3 biopsy types in ulceration (P = .018, chi2) and regression (P = .022, chi2); there were no differences in age, gender, Breslow thickness, Clark level, lymphovascular invasion, tumor location, or histologic subtype. Biopsy type did not significantly affect LRR, DFS, DDFS, or OS.
Conclusions: The concern that incomplete excision of primary melanomas may result in an increased incidence of SLN micrometastases, artifactual or real, is unfounded. Similarly, there is no evidence that biopsy type adversely affects locoregional or distant recurrence. Although shave biopsy is generally discouraged because it may lead to inaccurate tumor thickness measurements, it does not appear to affect overall patient outcome.
Similar articles
-
Should all patients with melanoma between 1 and 2 mm Breslow thickness undergo sentinel lymph node biopsy?Cancer. 2010 Mar 15;116(6):1535-44. doi: 10.1002/cncr.24895. Cancer. 2010. PMID: 20108306
-
Regression does not predict nodal metastasis or survival in patients with cutaneous melanoma.Am Surg. 2011 Aug;77(8):1009-13. Am Surg. 2011. PMID: 21944515 Clinical Trial.
-
Clinical and histopathological risk factors to predict sentinel lymph node positivity, disease-free and overall survival in clinical stages I-II AJCC skin melanoma: outcome analysis from a single-institution prospectively collected database.Eur J Cancer. 2009 Sep;45(14):2537-45. doi: 10.1016/j.ejca.2009.05.034. Epub 2009 Jun 22. Eur J Cancer. 2009. PMID: 19553103
-
259 Patients with DCIS of the breast applying USC/Van Nuys prognostic index: a retrospective review with long term follow up.Breast Cancer Res Treat. 2008 Jun;109(3):405-16. doi: 10.1007/s10549-007-9668-7. Epub 2007 Aug 9. Breast Cancer Res Treat. 2008. PMID: 17687650 Review.
-
Ultra-late recurrence (15 years or longer) of cutaneous melanoma.Cancer. 1997 Jun 15;79(12):2361-70. Cancer. 1997. PMID: 9191524 Review.
Cited by 15 articles
-
Effect of changes in Breslow thickness between the initial punch biopsy results and final pathology reports in acral lentiginous melanoma patients.Sci Rep. 2021 Oct 6;11(1):19885. doi: 10.1038/s41598-021-99422-6. Sci Rep. 2021. PMID: 34615974 Free PMC article.
-
Impact of Biopsy Technique on Clinically Important Outcomes for Cutaneous Melanoma: A Systematic Review and Meta-analysis.Mayo Clin Proc Innov Qual Outcomes. 2020 Jul 15;4(4):373-383. doi: 10.1016/j.mayocpiqo.2020.04.005. eCollection 2020 Aug. Mayo Clin Proc Innov Qual Outcomes. 2020. PMID: 32793865 Free PMC article. Review.
-
Sentinel Lymph Node Biopsy and Complete Lymph Node Dissection for Melanoma.Curr Oncol Rep. 2019 Apr 26;21(6):54. doi: 10.1007/s11912-019-0798-y. Curr Oncol Rep. 2019. PMID: 31028497 Free PMC article. Review.
-
Differences in cutaneous melanoma treatment and patient satisfaction.PLoS One. 2018 Oct 25;13(10):e0205517. doi: 10.1371/journal.pone.0205517. eCollection 2018. PLoS One. 2018. PMID: 30359387 Free PMC article.
-
United States Preventive Services Task Force Overstates Cosmetic Harms of Skin Cancer Screening.J Clin Aesthet Dermatol. 2018 Apr;11(4):52-53. Epub 2018 Apr 1. J Clin Aesthet Dermatol. 2018. PMID: 29657674 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical