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Skin-Melanocytic Tumors

Breslow’s system for tumor thickness


Last major update: November 2008

Revised: 1 December 2010

Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.

Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.




● Breslow thickness is an important prognostic factor (Cancer 2000;88:589)

● Measure tumor thickness with ocular micrometer at right angles to surface of adjacent normal skin, from (a) top of granular layer of overlying epidermis OR from ulcer base over deepest point of invasion to (b) deepest invasive tumor cells

● Traditional categories are 0 to 0.76 mm, 0.76 to 1.49 mm, 1.50 mm to 3.99 mm and greater than 4.00 mm

● New staging systems use 1 mm increments

● 5 year survival in nonulcerated tumors is 97% for Breslow thickness of 0 to 1.0 mm, 91% for 1.01 to 2.0 mm, 79% for 2.01 to 4.0 mm and 71% for > 4.0 mm (AJCC 7th Edition, 2010)

● Frozen section measurements may be accurate (Histopathology 1999;34:257)






Breslow depth


Additional references




End of Skin-Melanocytic Tumors > Breslow’s system for tumor thickness




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