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Sampling of wide local excision specimens in cutaneous malignant melanoma
Author(s) -
Fives Cassie,
Heffron Cynthia C. B. B.
Publication year - 2018
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13083
Subject(s) - biopsy , sampling (signal processing) , medicine , melanoma , wide local excision , lesion , sampling error , dermatology , reduction (mathematics) , radiology , pathology , surgery , statistics , computer science , geometry , mathematics , filter (signal processing) , cancer research , observational error , computer vision
Background Wide local excisions (WLEs) are frequently undertaken in the management of cutaneous melanoma; however, there is a considerable variability in their macroscopic sampling. The aim of our study was to establish evidence‐based guidelines for the macroscopic handling of these specimens with a subsequent review of the impact on our service. Methods The study group of 128 cases with initial biopsy and subsequent WLE in our institution in 2010 were identified by a computer‐generated search. From analysis of this group, guidelines for macroscopic sampling were derived with a repeat search performed in 2012. Results Residual melanoma was detected only in those cases in which the original specimen had clear margins of ≤1 mm or with a pigmented lesion. A 32% increase in case numbers was noted over this period with a reduction of 6.2% in block numbers. Average block numbers per case were reduced by 2.3 (30.7%). Conclusions We have shown that for WLE specimens with no evidence of a macroscopic lesion and clear margins on original biopsy, little is to be gained from extensive sampling. In these cases we recommend a maximum of 3 blocks per case. Reduction in sampling based on this evidence would result in saving valuable laboratory resources.