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[5 min read] Melanoma size not a reliable predictor of invasion | Prof David Wilkinson
This month’s paper is from the SCARD database, and reports on the features of over 600 melanomas diagnosed by almost 30 GPs across Australia.
For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Skin Cancer Medicine.
Many of us know all about SCARD and the remarkable data and insights that it is generating: over 1 million entries in SCARD now. I strongly recommend a careful reading of the paper linked below.
However, one key finding that has already influenced my practice is that very small (micro) melanomas are at least as likely to be invasive as larger melanomas.
Just think about this carefully for a moment: size (diameter) is not a reliable predictor of invasion. And this finding is confirmed from other studies, including an analysis of data reported by the Melanoma Institute of Australia at this year’s Global Advances & Controversies conference in Brisbane.
Think about the implications of this: it means that we cannot assume that a small (diameter) melanoma will be in situ and therefore “safe” until it is bigger (in diameter) and before it becomes invasive.
So, our goal of finding as many melanomas as possible before they become invasive just became harder, because many will be tiny (less than 5mm diameter). So, the potential power of total body photography (which can identify new lesions before they become large) becomes even more relevant.
– Prof David Wilkinson
Tiny melanoma 2.5 x3.5 mm with Breslow 1.7mm.
Micro melanoma 1.2mm with Breslow 0.2mm .
At the recent Cancer Council of WA WAKMAS presentation on Melanoma the dermatologist presenting for the first time amongsrt presenters in over ten years gave a positive view of TBP but then put up his clinical guide to assist GP’s find melanoma which had a presentation point of:
Melanoma > 6mm .
Really ? What else can I say…