Breslow thickness

Posted By
10/9/2017 4:31pm
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Replies: 6


I am new to all this. Had a shave biopsy a month ago that came back as melanoma. Path report lists the Breslow thickness 'at least .44' and the Clark level 'at least III'.  Four days ago I had the tumor out (not the WLE), &  in 2 weeks I go back to get stitches out & find out what's next.

My question is: how accurate is this due to having a shave biopsy and do I assume that those numbers will go up since it was only a tiny piece of a pretty large spot?


Janner - (10/10/2017 - 10:56am)

Unforunately, there is no way to know.  What you will find out is the depth of the lesion that was NOT biopsied.  The biopsied part will not give you any further info.  Even if they were to find more melanoma under that area, you can't just "add" the depth to the biopsy depth because the samples will never match up.  Shave biopsies are not the best choice for staging melanoma because this information is compromised.  So your melanoma is "at least" .44mm.  However since it appears this was only a partial biopsy, you will be able to get a definitive depth of the remaining portion.

Irishone21 - (10/10/2017 - 9:38pm)

Thanks Janner. I don't think my derm thought it was melanoma & that's why they did a shave biopsy. I had noticed it went from flat to raised & because of that, she biopsied it. My primary care doc told me to have my derm check it, but thought it was 'fine'. Makes me realize how important it is to check myself & keep track with pictures etc.

Do you think everyone in this situation needs a surgical oncologist or is staying with a regular dermatologist enough?

Janner - (10/10/2017 - 10:36pm)

Depends - I'd want to see the depth of the rest of the lesion.  I've had 3 primaries, all stage 1b or less.  I've never seen a surgical oncologist.  My derm is a cutaneous oncologist - he only sees cancer related skin issues.  I've had a regular derm and this derm do all my excisions.  I'm fine with that.  But if you need a sentinel node biopsy, then that changes the playing field and it makes sense to go with the surgical oncologist because you need someone to do the SNB and knows their stuff.

Irishone21 - (10/11/2017 - 8:37pm)

Good advice, thank you!

SDFun - (10/12/2017 - 7:51pm)


My initial shaved biosby was .39 and I was told by my derm and a surgeon frined that I needed to have sential nodes tested when I had the esxcison. unforuataly 1 was positive but at least now we can plan for it. I think you need to get a second opion on wheather or not you need sentail nodes tested, each case is different

Irishone21 - (10/12/2017 - 9:22pm)


I'm sorry to hear about your results. I go back to my doc in a week to get my stitches out & get the path results. My gut tells me he's going to want me to have the snlb, which I would def agree to put my mind at ease. What were your final path results for your excision?