Skin - Melanocytic tumor
Miscellaneous
Breslow system for tumor thickness

Author: Christopher Hale, M.D. (see Authors page)

Revised: 20 February 2017, last major update May 2013

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Breslow system tumor thickness

Cite this page: Breslow system for tumor thickness. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/skintumormelanocyticbreslow.html. Accessed May 23rd, 2017.
Definition / general
  • Important prognostic factor (Cancer 2000;88:589, Wikipedia, Cancer 2001;91:983) first described by Breslow in 1970 (Ann Surg 1970;172:902)
  • 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
  • 2009 AJCC Staging System employs the following thresholds for thickness:
    • T1: ≤ 1.00 mm thickness
    • T2: 1.01 to 2.00 mm thick
    • T3: 2.01 to 4.00 mm thick
    • T4: more than 4.00 mm (J Clin Oncol 2009;27:6199)
  • 10 year survival: 92% for melanoma < 1.00 mm thick; 80% if 1.01 to 2.00 mm thick; 63% if 2.01 to 4.00 mm thick; 50% if > 4.00 mm thick (J Clin Oncol 2009;27:6199)
  • 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 (Edge: AJCC Cancer Staging Manual, 7th ed, 2010)
  • Frozen section measurements may be accurate (Histopathology 1999;34:257)
Diagrams / tables

Images hosted on other servers:

Breslow depth

TNM staging categories for cutaneous melanoma