Microstaging accuracy after subtotal incisional biopsy of cutaneous melanoma

Darius J. Karimipour, Jennifer L. Schwartz, Timothy S. Wang, Christopher K. Bichakjian, Jeffrey S. Orringer, Anya L. King, Conway C. Huang, Timothy M. Johnson

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


Background: A significant portion of cutaneous melanoma may remain after subtotal incisional biopsy. The accuracy of microstaging and impact on clinical practice in this scenario are unknown. Objective: Our purpose was to examine microstaging accuracy of an initial incisional biopsy with a significant portion of the clinical lesion remaining (≥50%). Methods: Patients with cutaneous melanoma, diagnosed by incisional biopsy with ≥50% of the lesion remaining, were prospectively evaluated for microstaging accuracy, comparing initial Breslow depth (BD1) to final depth (BD2) after excision of the residual lesion. Impact on prognosis and treatment was also evaluated. Results: Two hundred fifty of 1783 patients (14%) presented with ≥50% residual clinical lesion after incisional biopsy. The mean BD1 was 0.66 mm; the mean BD2, 1.07 mm (P =. 001). After complete excision of the residual lesion, upstaging occurred in 21% and 10% became candidates for sentinel node biopsy. Conclusion: An incisional biopsy with ≥50% clinical lesion remaining afterward may be inadequate for accurate microstaging of melanoma. This scenario is relatively uncommon but clinically significant.

Original languageEnglish (US)
Pages (from-to)798-802
Number of pages5
JournalJournal of the American Academy of Dermatology
Issue number5
StatePublished - May 2005

ASJC Scopus subject areas

  • Dermatology


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