title: The impact of biopsy technique on upstaging, residual disease, and outcome in cutaneous melanoma.
abstract: BACKGROUND
  After skin biopsy of malignant melanoma, the findings in the subsequent wide local excision (WLE) sometimes result in upgrading of the T-category. Herein, we examine the influence of biopsy technique on residual disease in melanoma WLE specimens and on upstaging.
  
  
  METHODS
  We performed a retrospective review of data from malignant melanoma patients who underwent sentinel lymph node biopsy between 1997 and 2010.
  
  
  RESULTS
  A total of 609 patients were biopsied by shave (51%), punch (19%), and excision (30%). Residual disease was seen in 240 patients (39%) at WLE, of whom 60% had undergone shave biopsy. Fifty-nine patients had a T-category upgrade after WLE (10% of all patients); 64% were sampled by shave. Seven percent of patients with a T-category upgrade had negative margins initially. Positive biopsy margin and greater thickness predicted T-category upgrade.
  
  
  CONCLUSIONS
  Partial biopsy for melanoma resulted in more residual disease at WLE and a higher rate of T-category upgrade. Moreover, the presence of negative margins at biopsy did not ensure lack of residual disease.
authors: Department of Dermatology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
authors: Geneviève L
authors: GL
authors: Egnatios
authors: Amylou C
authors: AC
authors: Dueck
authors: James B
authors: JB
authors: Macdonald
authors: Susan D
authors: SD
authors: Laman
authors: Karen E
authors: KE
authors: Warschaw
authors: David J
authors: DJ
authors: DiCaudo
authors: Shari A
authors: SA
authors: Nemeth
authors: Aleksandar
authors: A
authors: Sekulic
authors: Richard J
authors: RJ
authors: Gray
authors: Nabil
authors: N
authors: Wasif
authors: Barbara A
authors: BA
authors: Pockaj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D018365:Neoplasm, Residual / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult