 |
|
Melanoma and Tumor Thickness
Challenges of Early Diagnosis
Marie Aleth Richard, MD*;
Jean Jacques Grob, MD*;
Marie Françoise Avril, MD*;
Michèle Delaunay, MD*;
Xavier Thirion, MD;
Pierre Wolkenstein, MD*;
Pierre Souteyrand, MD*;
Brigitte Dreno, MD*;
Jean Jacques Bonerandi, MD*;
Sophie Dalac, MD*;
Laurent Machet, MD;
Jean Claude Guillaume, MD*;
Jacqueline Chevrant-Breton, MD*;
Catherine Vilmer, MD*;
François Aubin, MD*;
Bernard Guillot, MD*;
Marie Beylot-Barry, MD;
Catherine Lok, MD*;
Nadia Raison-Peyron, MD;
Philippe Chemaly, MD*
Arch Dermatol. 1999;135:269-274.
Objective To test the basic assumption of campaigns for early diagnosis of melanoma, ie, prognosis is correlated with the delay in the diagnosis.
Design Prospective study of the correlation between delays to diagnosis, assessed using a questionnaire, and the Breslow thickness as a prognosis marker.
Setting Dermatology departments in France.
Patients Five hundred ninety consecutive patients, referred within 12 weeks after resection of cutaneous melanoma.
Main Outcome Measures Assessment of 5 successive time intervals from the first time the patients realized that they had a lesion until the resection of the melanoma, and results of the correlation between each time interval and tumor thickness (Breslow).
Results There is a positive but weak correlation between tumor thickness and the delay to identify a lesion as suspicious (r=0.17; P=.009). However, this delay tends to be short for the thickest tumors. There is a negative correlation between tumor thickness and the delay to seek medical attention (r=-0.20; P<.001). This delay was shorter for nodular melanoma. No correlation is found between melanoma thickness and physicians' delays.
Conclusions Poor prognosis can be accounted for by aggressive rapidly growing tumors rather than by delays. In well-informed populations, campaigns for early diagnosis of melanoma may thus no longer have a major impact on prognosis, unless they are focused on subgroups less accessible to information and medical care.
The affiliations of authors appear in the acknowledgment section at the end of the article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Superior survival of females among 10 538 Dutch melanoma patients is independent of Breslow thickness, histologic type and tumor site
de Vries et al.
Ann Oncol 2008;19:583-589.
ABSTRACT
| FULL TEXT
Effect of Health Care Delivery Models on Melanoma Thickness and Stage in a University-Based Referral Center: An Observational Pilot Study
Swetter et al.
Arch Dermatol 2007;143:30-36.
ABSTRACT
| FULL TEXT
Rate of Growth in Melanomas: Characteristics and Associations of Rapidly Growing Melanomas
Liu et al.
Arch Dermatol 2006;142:1551-1558.
ABSTRACT
| FULL TEXT
The relationship between melanoma thickness and time to diagnosis in a large population-based study.
Baade et al.
Arch Dermatol 2006;142:1422-1427.
ABSTRACT
| FULL TEXT
Evaluating early detection in the diagnosis of melanoma.
Berwick
Arch Dermatol 2006;142:1485-1486.
FULL TEXT
Early Detection of Thick Melanomas in the United States: Beware of the Nodular Subtype
Demierre et al.
Arch Dermatol 2005;141:745-750.
ABSTRACT
| FULL TEXT
Dermatologist Detection and Skin Self-examination Are Associated With Thinner Melanomas: Results From a Survey of the Italian Multidisciplinary Group on Melanoma
Carli et al.
Arch Dermatol 2003;139:607-612.
ABSTRACT
| FULL TEXT
Dermoscopy of Pigmented Seborrheic Keratosis: A Morphological Study
Braun et al.
Arch Dermatol 2002;138:1556-1560.
ABSTRACT
| FULL TEXT
Nodular Type and Older Age as the Most Significant Associations of Thick Melanoma in Victoria, Australia
Chamberlain et al.
Arch Dermatol 2002;138:609-614.
ABSTRACT
| FULL TEXT
Early Detection of Melanoma
Weinstock
JAMA 2000;284:886-889.
FULL TEXT
Melanoma and Tumor Thickness
Goldman et al.
Arch Dermatol 2000;136:122-123.
FULL TEXT
Thickness and Delay in Diagnosis of Melanoma: How Far Can We Go?
MacKie
Arch Dermatol 1999;135:339-340.
FULL TEXT
|
