Breslow’s system for tumor thickness
Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 7 June 2013, last major update May 2013
Copyright: (c) 2002-2013, PathologyOutlines.com, Inc.
- 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 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, table)
- 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 non-ulcerated 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)
End of Skin-melanocytic tumor > Miscellaneous > Breslow’s system for tumor thickness
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