There are many different aspects to the treatment and management of primary melanoma, but clinicians differ on their perceptions of the ideal treatment approach.
“Unfortunately, there is no real consensus on several different aspects of the management of the primary melanoma lesion. Many of the recommendations from the National Comprehensive Cancer Network (NCCN) are vague, leaving much up to the interpretation of the clinician and reliance on their training,” says Emmanuel M. Gabriel, M.D., Ph.D., senior associate consultant, section of surgical oncology, department of general surgery, Mayo Clinic, Jacksonville, Fla., who spoke at the 4th Annual Mayo Clinic Cutaneous Oncology Symposium in Orlando.
There are a number of different techniques that the clinician can choose from to biopsy malignant melanoma including punch and shave biopsy procedures. According to Dr. Gabriel, analysis of the National Cancer Database (NCDB) indicates punch biopsies are more favorable with approximately 60% to 65% of clinicians opting to use this technique. This is closely followed by shave biopsies.
In polling the audience during his presentation, he reported there was essentially an even distribution of how clinicians perform the biopsy, with 1/3 doing punch biopsies, 1/3 doing shave biopsies, and 1/3 doing excisional biopsies.
Although there is no survival benefit associated with biopsy technique, Dr. Gabriel says the choice of procedure is very important to optimizing the further management of the patient.