December 21, 2024, 1:54 pm | Read time: 2 minutes
Malignant melanomas, better known as black skin cancer, are grouped into stages based on their thickness, among other things. This is, therefore, considered a key factor for the survival chances of patients. However, a recent study has now uncovered unexpected subtleties in this context. Its findings could call into question the current treatment practice based on the standard classification.
The tumor thickness, according to Breslow, the so-called Breslow level, has been used in cancer medicine for many years as a histological classification of malignant melanomas.1 It is the common measure for the depth of tumors and is measured from the skin surface to its deepest point. To this day, the Breslow level is considered the most important parameter for the prognosis of malignant melanoma – the thicker, the more dangerous, according to the assumption – and influences the treatment approach. Current research results now suggest that new threshold values should be used, as the risk of thin melanomas is apparently often underestimated.2
Study on the Underestimated Risk of Thin Melanomas
The current study looked at the connection between subtle increases in the thickness of malignant melanomas and the chances of survival of those affected. It was conducted at the University of Sydney in Australia – a country with a notoriously high incidence of skin cancer.
For the study, the researchers analyzed data from cancer registries in all Australian states and territories from a data collection period between 1982 and 2014. They only included cases of thin invasive primary melanomas – those with a thickness of up to one millimeter. According to the Breslow classification, these are rated as having a survival rate of 90 percent, which is very high. The survival rate only drops to 70 to 80 percent within five years for tumors with a thickness of two millimeters or more. Until now, there has been a lack of precise data on the influence of finer gradations below the 1-millimeter mark on the prognosis of skin cancer. The researchers have now determined this.
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Unexpected Influence on Survival Rate for Skin Cancer
When evaluating the data of 144,447 patients, the researchers found a significantly increased risk of skin cancer mortality in those whose melanomas exceeded a thickness of 0.8 millimeters.
Within the group of thin melanomas, hardly any distinction has been made between different thicknesses in medical practice to date. With their study, the researchers have now been able to show that even in these cases of skin cancer, which are considered harmless, even slight differences in size – for example, within the range of 0.7 to 0.9 millimeters – can have a significant impact on the chances of survival. They recommend that the threshold value of 0.8 millimeters be included in medical practice as a “guideline for treatment.”