Prognostic Importance
Tumor depth is one of the cornerstones of the current AJCC TNM staging of malignant melanoma. A large study validated the importance of tumor depth (but not Breslow's original description) as one of the three most important prognostic factors in melanoma (the others being T stage and ulceration). Breslow's depth also accurately predicted the risk for lymph node metastasis, with deeper tumors being more likely to involve the nodes.
The above studies showed that depth was a continuous variable correlating with prognosis. However, for staging purposes, the most recent AJCC guidelines use cutoffs of 1 mm, 2 mm, and 4 mm to divide patients into stages.
| Tumor Depth | Approximate 5 year survival |
|---|---|
| <1 mm | 95-100% |
| 1 - 2 mm | 80-96% |
| 2.1 - 4 mm | 60-75% |
| >4 mm | 50% |
Survival figures from British Association of Dermatologist Guidelines 2002
Breslow thickness in the presence of ulceration also gives useful prognostic information.
Read more about this topic: Breslow's Depth
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