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Melanoma — SCE Dermatology MCQ

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HardSkin CancerMelanomaSCE Dermatology

Histology after complete excision shows a non-ulcerated melanoma with Breslow thickness 1.1 mm and no microsatellites. Staging examination is normal. Which next staging discussion follows NICE NG14?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Discuss sentinel lymph-node biopsy because Breslow thickness is greater than 1.0 mm

Explanation lettering: C = shown as A · E = shown as B · A = shown as C · B = shown as D · D = shown as E

E is correct. NICE recommends considering sentinel lymph-node biopsy when Breslow thickness is greater than 1.0 mm. The discussion covers prognostic information, the possibility of identifying stage III disease and the procedure’s limitations and morbidity. Completion lymph-node dissection is not performed before sentinel staging. Breslow thickness is measured from viable invasive melanoma and is not mathematically adjusted for regression. Absence of ulceration influences T category and prognosis but does not remove the greater-than-1.0-mm NICE criterion.

Reference: NICE NG14: melanoma assessment and management: https://www.nice.org.uk/guidance/ng14/chapter/Recommendations