#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.
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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