Breslow thickness measures the depth of melanoma growth and is used to determine the prognosis and appropriate treatment plan. Tumors less than 1mm have a good prognosis, while those larger than 4mm have a lower survival rate. Dr. Alexander Breslow is credited with recognizing the connection between tumor invasion and patient prognosis. Patients have the right to clear information about their condition and treatment options.
Breslow thickness is a measure of the size of a melanoma growth expressed in terms of how deeply the growth has penetrated the epidermis. The deeper the Breslow thickness, the greater the chance of metastasis and the worse the prognosis for the patient. This is one of several measures used in the evaluation of patients with melanoma to develop an appropriate treatment plan.
When unusual skin growths are identified in a patient, the growths are removed and examined in the laboratory to determine whether they are malignant and to gather more information about them. In the case of melanoma, the pathologist will measure the height of the tumor to determine the Breslow thickness, expressed in millimeters. If the tumor is less than 1 millimeter tall, there is a 95 to 100 percent five-year survival rate for the patient, a very good prognosis. Tumors between 1 and 2 millimeters have a five-year survival rate of 80 to 96%, while growths larger than 2 millimeters and less than 4 millimeters have a reduced survival rate, around 60 to 70%.
Larger tumors, more than 4 millimeters in height, have an estimated 37 to 50% patient survival rate. A high Breslow thickness is an indicator of aggressive treatment to increase the patient’s chances, coupled with close monitoring for any signs of metastases to allow doctors to address further growths as soon as possible. Medical imaging studies may be recommended to look for growths in other areas of the body, and the patient may receive aggressive chemotherapy and other treatments to address the melanoma.
Dr. Alexander Breslow is generally credited with recognizing the connection between the level of tumor invasion and the prognosis for the patient, during research conducted in the 1970s. Measurements of the thickness of melanoma growths are known as Breslow’s thickness in honor of his research. Doctors may also use other terms to describe a melanoma, including the Clark level, looking specifically at how many layers of skin the cancer has penetrated, and staging, referring to how aggressive the cancer is and how likely it is to metastasize.
A diagnosis of melanoma can be scary, especially when technical terms like Breslow thickness start getting thrown around. Patients have the right to ask for clear and understandable descriptions of their medical conditions and to obtain information about treatment options, the prognosis with different types of treatment and what to expect from treatment so they can make informed choices and their options.
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