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Cutaneous melanoma — RACP Adult Medicine MCQ

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EasyDermatologyCutaneous melanomaRACP Adult Medicine

A 46-year-old man has excision of a superficial spreading melanoma from his upper back. Histology shows Breslow thickness 2.4 mm, ulceration present and clear margins. He asks which histological feature most strongly predicts outcome. What is the most important prognostic factor?

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Correct answer: A — Breslow tumour thickness

Breslow thickness is the most important histological prognostic factor in primary cutaneous melanoma and guides staging and sentinel node discussion. Ulceration also matters, but thickness is central. Dermoscopic colour, site, sunburn recall and gross diameter are less prognostically decisive than invasion depth.

Reference: Cancer Council Australia melanoma guidelines; eTG