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Brown H, De'Ambrosis B, Yong-Gee S, Muir J. Reply to: Adler et al.'s Melanoma diagnosis at a specialist dermatology practice without the use of photographic surveillance. Australas J Dermatol 2023; 64:e399-e400. [PMID: 37394876 DOI: 10.1111/ajd.14124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Affiliation(s)
- Hilary Brown
- Mater Hospital, South Brisbane, Queensland, Australia
- South East Dermatology, Annerley, Queensland, Australia
| | - Brian De'Ambrosis
- South East Dermatology, Annerley, Queensland, Australia
- University of Queensland, Medical Faculty, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Simon Yong-Gee
- South East Dermatology, Annerley, Queensland, Australia
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - James Muir
- Mater Hospital, South Brisbane, Queensland, Australia
- South East Dermatology, Annerley, Queensland, Australia
- University of Queensland, Medical Faculty, Brisbane, Queensland, Australia
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2
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Brown H, De'Ambrosis B, Yong-Gee S, Griffin A, Muir J. Melanoma diagnosis at a specialist dermatology practice without the use of photographic surveillance. Australas J Dermatol 2023; 64:234-241. [PMID: 36774586 DOI: 10.1111/ajd.14008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND/OBJECTIVE Photographic aides are increasingly used in melanoma surveillance. We report melanoma characteristics detected using traditional surveillance without photographic technologies. METHODS Retrospective study of melanomas diagnosed by three dermatologists at a private dermatology practice over 7 years. Patients underwent full skin examinations with dermoscopy and suspect lesions were excised or biopsied. Total body photography (TBP) and serial digital dermoscopic imaging (SDDI) were not used. Patient demographics, melanoma subtype and thickness, location, biopsy technique and keratinocyte cancers diagnosed at the same visit were recorded. Ratio of in situ to invasive melanomas was calculated. Melanoma risk factors were recorded for 69 randomly-selected patients. RESULTS 492 patients were diagnosed with 615 melanomas during 579 visits. 505 (82%) were in situ (in situ to invasive ratio of 4.6:1). Of the invasive melanomas, 85.5% had a Breslow thickness <0.8 mm, 10 (9.1%) 0.8-1 mm and 6 (5.5%) >1 mm. 43.3% of in situ melanomas were lentiginous or lentigo maligna and 41.6% were superficial spreading melanomas (SSM). Of invasive melanomas, 24.3% were lentigo maligna melanoma and 59.5% were SSM. 48.4% of melanomas were diagnosed by shave procedures. Where risk factors were known, 25% were very-high-risk and 43% had a history of melanoma. Keratinocyte carcinoma was diagnosed by biopsy at 26.1% of visits. Studies using TBP and/or SDDI report in situ to invasive ratios of 0.59:1 to 2.17:1. CONCLUSION Tradiational melanoma surveillance with immediate biopsy of suspect lesions results in high in situ to invasive ratios. Studies using photographic surveillance show lower ratios of in situ to invasive disease.
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Affiliation(s)
- Hilary Brown
- Mater Hospital, South Brisbane, Queensland, Australia
- South East Dermatology, Annerley, Queensland, Australia
| | - Brian De'Ambrosis
- South East Dermatology, Annerley, Queensland, Australia
- Medical Faculty, University of Queensland, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Simon Yong-Gee
- South East Dermatology, Annerley, Queensland, Australia
- Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Alison Griffin
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - James Muir
- Mater Hospital, South Brisbane, Queensland, Australia
- South East Dermatology, Annerley, Queensland, Australia
- Medical Faculty, University of Queensland, Brisbane, Queensland, Australia
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3
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Rosendahl C, Clark S. General practice and melanoma management in Australia: controversies and implications for generalist GP training. Med J Aust 2023; 218:397-398. [PMID: 37055031 DOI: 10.5694/mja2.51928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 04/15/2023]
Affiliation(s)
- Cliff Rosendahl
- The University of Queensland Medical School, the University of Queensland, Brisbane, QLD
- Tehran University of Medical Sciences, Tehran, Iran
| | - Simon Clark
- Tehran University of Medical Sciences, Tehran, Iran
- The University of Queensland, Brisbane, QLD
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So C, McCarthy D, Watts CG, Kearney C, Reyes-Marcelino G, Goldsbury DE, McLoughlin K, Emery J, Cust AE. Diagnostic biopsies of suspected skin cancer in general practice from 2010 to 2017 in Victoria, Australia. Br J Dermatol 2022; 188:560-561. [PMID: 36689340 DOI: 10.1093/bjd/ljac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/10/2022] [Accepted: 11/28/2022] [Indexed: 01/22/2023]
Affiliation(s)
- Chi So
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Caroline G Watts
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | | | - Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,The Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - David E Goldsbury
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Kirstie McLoughlin
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Jon Emery
- Department of General Practice.,Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Services, The University of Melbourne, Melbourne, VIC, Australia
| | - Anne E Cust
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia.,The Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
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Ludzik J, Lee C, Witkowski A, Hetts J. Minimizing sampling error using a unique ink-stained reflectance confocal microscopy-guided biopsy technique to diagnose a large lentigo maligna. JAAD Case Rep 2022; 24:118-120. [PMID: 35677149 PMCID: PMC9168378 DOI: 10.1016/j.jdcr.2022.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Joanna Ludzik
- Department of Telemedicine and Bioinformatics, Jagiellonian University Medical College, Krakow, Poland
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon
| | - Claudia Lee
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon
- School of Medicine, University of California Riverside, Riverside, California
- Correspondence to: Claudia Lee, BS, Department of Dermatology, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239.
| | - Alexander Witkowski
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon
| | - Jonathon Hetts
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon
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Fomina LV, Aslanyan SA, Gumeniuk KV, Fomin OO, Trutyak I. PERFECT BIOPSY METHODS FOR THE DIAGNOSIS OF MALIGNANT MELANOCYTIC SKIN NEOPLASMS (A LITERATURE REVIEW). BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-4-167-92-98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | | | | | - O. O. Fomin
- National Pirogov Memorial Medical University
| | - I.R. Trutyak
- Danylo Halytsky Lviv National Medical University
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Mazzoni D, Shao E, Brown H, Muir J. A reply to 'The impact of incomplete clinical information and initial biopsy technique on the histopathologic diagnosis of cutaneous melanoma'. Australas J Dermatol 2021; 63:e106-e107. [PMID: 34699059 DOI: 10.1111/ajd.13732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/02/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel Mazzoni
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Emily Shao
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Sunshine Coast University Hospital, Queensland, Australia
| | | | - Jim Muir
- Mater Hospital, Brisbane, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
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8
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Kok Y, Scott K, Pham A, Liu W, Roberts H, Pan Y, McLean C, Chamberlain A, Kelly JW, Mar VJ. The impact of incomplete clinical information and initial biopsy technique on the histopathological diagnosis of cutaneous melanoma. Australas J Dermatol 2021; 62:e524-e531. [PMID: 34426977 DOI: 10.1111/ajd.13697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/11/2021] [Accepted: 07/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Increased rates of histopathological misdiagnosis of melanoma have been associated with incisional punch more so than shave biopsy when compared with complete excisional biopsy. It is unknown how the increasing utilisation of shave biopsy may impact melanoma diagnosis. The extent to which the provision of clinical information to the pathologist may improve diagnostic accuracy remains unclear. This study assessed the impact of both initial biopsy technique and provision of adequate clinical information to pathologists on the accuracy of histopathological diagnosis of melanoma and disease progression. METHODS We conducted a retrospective cohort with nested case-control study of all histopathological false-negative and false-positive melanoma diagnoses from January 2014 to May 2019 from the Victorian Melanoma Service electronic database. Cases were assessed for the initial biopsy type, provision of clinical information on pathology request forms and disease progression associated with false-negative diagnosis. RESULTS Partial shave biopsy had higher odds of false-negative (OR 5.19, 95% CI 2.89-9.32; P < 0.001) and false-positive diagnoses (OR 1.95, 95% CI 1.45-2.63; P < 0.001) of melanoma when compared with elliptical excisional biopsy. These odds ratios were comparable with those found with incisional punch biopsy. Providing the suspected clinical diagnosis to pathologists also reduced the odds of false-negative diagnosis with melanoma progression by 3.8-fold (P = 0.02). CONCLUSION The choice of initial biopsy technique and providing the suspected clinical diagnosis to pathologists are important for correct histopathological diagnosis of cutaneous melanoma and prevention of further disease progression.
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Affiliation(s)
- Yonatan Kok
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Karen Scott
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alan Pham
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Anatomical Pathology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Wenyuan Liu
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Hugh Roberts
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Skin Health Institute, Melbourne, VIC, Australia
| | - Yan Pan
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Catriona McLean
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Anatomical Pathology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alex Chamberlain
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - John W Kelly
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Victoria J Mar
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Pitney T, Muir J. The use of shave excision by dermatologists in Australia: A consensus survey. Australas J Dermatol 2021; 62:514-517. [PMID: 34363686 DOI: 10.1111/ajd.13664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/30/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas Pitney
- Princess Alexandra Hospital Dermatology Department, Woolloongabba, Qld, Australia
| | - James Muir
- University of Queensland and The Mater Public Hospital Brisbane, Qld, Australia
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10
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Brown H, Pitney T, Muir J. Base Transection with Shaves: An Avoidable Shortcoming : Reply to Impact of Shave Biopsy on Diagnosis and Management of Cutaneous Melanoma: A Systematic Review and Meta-analysis. Ann Surg Oncol 2021; 28:821-822. [PMID: 34028635 DOI: 10.1245/s10434-021-10180-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Hilary Brown
- Mater Hospital, South Brisbane, QLD, Australia. .,South East Dermatology, 9/461 Ipswich Road, Annerley, QLD, 4103, Australia.
| | - Thomas Pitney
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - James Muir
- Mater Hospital, South Brisbane, QLD, Australia.,South East Dermatology, 9/461 Ipswich Road, Annerley, QLD, 4103, Australia.,Medical Faculty, University of Queensland, Brisbane, QLD, Australia
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11
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Pitney T, Shao E, Muir J. A Reply to 'Think before you shave: factors influencing choice of biopsy technique for invasive melanoma and effect on definitive management'. Australas J Dermatol 2020; 62:96-97. [PMID: 32671817 DOI: 10.1111/ajd.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas Pitney
- The Mater Hospital Brisbane, Brisbane, Qld, Australia
| | - Emily Shao
- The Mater Hospital Brisbane, Brisbane, Qld, Australia.,Faculty of Medicine, University of Queensland, St Lucia, Qld, Australia
| | - James Muir
- The Mater Hospital Brisbane, Brisbane, Qld, Australia
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