#dermpathJC August 2018 summary:

#dermpathJC August 2018:

Thursday, August 30th, 9pm EST

Article discussed: Influence of variability in assessment of Breslow thickness, mitotic rate and ulceration among US pathologists interpreting invasive melanoma, for the purpose of AJCC staging

Authors: Laura Taylor, Kyle Hood, Lisa Reisch, Joann Elmore, Michael Piepkorn, Raymond Barnhill, Stevan Knezevich, Andrea Radick, David Elder

Temporary open access available at https://doi.org/10.1111/cup.13265

Summary author: Silvija P. Gottesman, MD (@SGottesmanMD)

Journal Club Summary:

Thin melanoma, a melanoma with less than 1mm Breslow thickness. Carries a good prognosis, however 15% of melanoma deaths documented in SEER resulted from thin melanomas metastases. Patients need their frequent skin checks.

7th ed AJCC versus 8th ed AJCC melanoma classification, note changes for T1 stage.

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Highest variability in mitotic count and ulceration was rarely reported by participants and experts, as most were seen in T2+ melanoma lesions, for which a SLN biopsy is routinely indicated.

Most variability was seen in staging of thin melanomas. The study saw 18% of reference T1a assessments upstaged and 28% of T1b assessments downstaged based on mitotic count disagreement. The source of the greatest variability was the recognition of mitotic figures.

Breslow thickness AJCC 8th edition – round to 1 number after the decimal point instead of 2 as in the 7th ed.

Next #dermpathJC is in September! See you then! 🙂

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