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Melanoma Staging

See quick reference tool produced by American Joint committee for Cancer 2009 for Melanoma staging of the skin.

Melanoma staging is a way of classifying the mole, or lesion/tumour, and this simply done by measuring the thickness of the lesion. It is sometimes referred to as the 'Breslow Depth' and the thicker a mole or lesion is, the more likely it is to have spread (metastasised) to other parts of the body. The classification is as follows:

  • Stage 0 – The melanoma is inset, confined to the epidermis
  • Stage 1 – less than 2mm
  • Stage 2 – more than 2mm
  • Stage 3 – where the cancer has spread to the lymphatic system
  • Stage 4 – where the cancer has spread to other parts of the body beyond the lymphatic system

Other considerations are:

  • Ulceration – if the mole is ulcerated it is more likely that the melanoma has spread (metastasised). It's not always possible to see ulceration with the naked eye.
  • Mitotic count – this is a count of the number of cancer cells that are actually dividing when the tissue is examined under a microscope. Larger numbers of dividing cells are associated with more aggressive types of melanoma
  • Lymph nodes containing melanoma – the larger the number of lymph nodes with melanoma present, the later the stage (see Sentinel Lymph Node Biopsy)

Precise staging classification can be determined by using any of the following techniques:

  • Wide local excision – removal of the lesion and surrounding tissue to check for the presence of cancerous cells
  • Sentinel Lymph Node Biopsy – see more about this procedure here
  • X Ray – generally an x ray of the chest
  • CT Scan / CAT Scan – CT stand for computerised tomography. CT scans in cases of melanoma are generally of the chest, abdomen and pelvis
  • MRI – MRI stands for magnetic resonance imaging and is another way of detecting what is happening inside the body
  • PET Scan – PET stand for Positron Emission Tomography and is used to detect malignant tumour cells
  • Blood Tests – particularly one to detect the presence of an enzyme called Lactate Hydrogenase (LDH) in melanoma cases