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dermatology oncology surgery

Melanoma Breslow Thickness and Staging

Stages cutaneous melanoma based on Breslow thickness, ulceration, and mitotic rate per AJCC 8th edition. Guides surgical margin and sentinel lymph node biopsy decisions.

Score interpretation

Melanoma in situ or T1a (<=1mm, no ulceration)

→ 5mm margin excision (in situ); 1cm margin for T1; sentinel node biopsy generally not recommended for T1a; dermatology follow-up 6-monthly x 2 years

T1b-T2 melanoma (ulceration or 1-2mm)

→ 1cm margin excision; consider SLNB for T1b (ulcerated or mitoses); 1-2cm margin for T2; oncology referral; imaging for N staging

T3-T4 melanoma (>2mm or ulcerated thick)

→ 2cm margin excision; SLNB recommended; full staging imaging (CT chest/abdomen/pelvis, MRI brain); oncology MDT; consider adjuvant immunotherapy (pembrolizumab/nivolumab) or targeted therapy if BRAF+

Interpretation bands for the Melanoma Breslow. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.