Breslow's staging
Breslow's staging, also known as Breslow thickness or Breslow measurement, is a critical assessment used to determine the vertical thickness of malignant melanoma tumors, measured in millimeters (mm). Developed in the 1970s by American pathologist Alexander Breslow, this staging method is employed after melanoma is confirmed through a skin biopsy. The primary purpose of Breslow's staging is to help oncologists evaluate the cancer's progression and decide on appropriate treatment options, which significantly influence recovery prospects.
The procedure involves obtaining a skin sample under local anesthesia, allowing for careful examination in a laboratory. Following the biopsy, the Breslow thickness assists in classifying the melanoma into one of five stages, ranging from early-stage tumors confined to the outer skin layer to advanced stages where cancer has spread to other body parts. The thickness of the tumor is a strong predictor of the five-year survival rate, with thinner tumors generally associated with better outcomes. This makes early diagnosis crucial, as it can greatly enhance the chances of successful treatment and recovery for patients facing melanoma.
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Breslow's staging
ALSO KNOWN AS: Breslow thickness, Breslow measurement, Breslow’s depth of invasiveness
DEFINITION: Breslow’s staging is a test to measure, in millimeters (mm), the vertical thickness (how far a tumor reaches into the skin) of a malignant melanoma tumor. The test was developed in the 1970s by Alexander Breslow (1928–1980), an American pathologist.
Cancers diagnosed:Melanoma, the most deadly form of skin cancer
Why performed: Once melanoma is confirmed by a skin biopsy, Breslow’s staging helps oncologists establish the progress, or stage, of the cancer and whether the cancer has spread. The stage helps oncologists choose the best treatment and determine the best prospects for recovery.
Patient preparation: No special preparation is needed for a skin biopsy.
Steps of the procedure: A skin is usually done in the doctor’s office. A local anesthetic is injected into the area with a small needle. A sample of skin tissue is then removed for examination.
After the procedure: The patient feels no pain and may go home. The skin sample is examined in a laboratory. If melanoma is confirmed, then the sample is subjected to Breslow’s staging to help determine prognosis and treatment.
Risks: Small skin biopsies are generally safe and carry only a small risk of bleeding or infection. Sometimes a biopsy may leave a scar.
Results: Early diagnosis is the most effective way of improving the cure rate for patients with melanoma. When laboratory tests confirm melanoma, Breslow’s staging classifies the progress of the cancer according to one of five stages. In the first stage, malignant melanoma cells are found only in the outer layer of skin and have not yet invaded the deeper layers or spread. Most patients with melanoma only in the outer layer of skin can be cured with surgery.
The Breslow thickness of a melanoma tumor predicts the approximate five-year survival rate after the tumor is surgically removed.
- Smaller than 1 mm: 95–100 percent
- 1.0–2.0 mm: 80–96 percent
- 2.1–4.0 mm: 60–75 percent
- More than 4.0 mm: 27-50 percent
In the last stage, the melanoma could be any thickness but has spread to other parts of the body, most likely to the nearest lymph nodes. The majority of patients with melanoma that has spread to nearby will likely need to undergo multiple treatment types, but the prognosis is typically poor as recurrence is typical.
Bibliography
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Thomas, Meirion. "Breslow Thickness and Clarke's Level." Malignant Melanoma. Malignant-melanoma.org, 28 Dec. 2007. Web. 12 Sept. 2014.