A female presented with a pigmented lesion with irregular border and variegated coloring diagnosed as melanoma. Which classification can be used for staging melanoma?
High-Yield Explanation
Melanoma Staging Committee of the American Joint Committee on cancer (AJCC) published the most recent melanoma TNM staging classification. Depth of invasion is the most impoant histologic prognostic parameter in primary melanoma. Breslow depth and Clark level are two different classifications of depth of invasion. Breslow depth is a quantitative measurement of the depth of invasion by measuring the tumor thickness with an ocular micrometer. Clark's staging refers to the histologic level of invasion, using the epidermis, papillary dermis, reticular dermis, and subcutaneous fat as the histologic boundaries. With the 2002 AJCC staging classification, tumor thickness measured by Breslow depth was determined to be primary factor for T staging. The presence of ulceration was found to be a powerful predictor of survival, and hence it is incorporated in the staging system. Ref: Plastic and Reconstructive Surgery edited by Maria Z. Siemionow, Marita Eisenmann-Klein, 2010, Page 217; DeVita, Hellman, and Rosenberg's cancer: principles 8t practice of oncology, 8th edition, Page 1908; Schwaz's Principles of Surgery, 9th edition, Chapter 16. The Skin and Subcutaneous Tissue.