title: The rate of melanoma transection with various biopsy techniques and the influence of tumor transection on patient survival.
abstract: BACKGROUND
  Depth of melanoma invasion is critical because it dictates patient treatment and prognosis. Recent reports indicate melanoma transection with initial biopsy does not impact patient survival; however, tumor transection can lead to misdiagnosis and inaccurate staging.
  
  
  OBJECTIVE
  This study assessed the rate of melanoma transection with various biopsy techniques and the impact of tumor transection on patient survival.
  
  
  METHODS
  We conducted a retrospective review of all melanoma cases at our institution between 2000 and 2008. Of the 490 melanoma cases identified, 479 met inclusion criteria for the study. The transection rates of biopsy techniques were determined. Cases of transected tumors were matched with nontransected cases in a retrospective case-control fashion to evaluate survival.
  
  
  RESULTS
  The rate of melanoma transection was 1.5% for excisional biopsies, 4.1% for punch biopsies, and 9.0% for saucerization biopsies. The means of disease-free survival for the control and transected groups were 911 days and 832.7 days, respectively (P value .67). Overall survival for the control group was 1073.7 days versus 1012.4 days for the transected group (P value .72).
  
  
  CONCLUSIONS
  The study used a select population. The sample size of transected biopsies was limited, in turn limiting the power of the study. Residents performed the majority of biopsies.
  
  
  CONCLUSIONS
  Punch and saucerization biopsies were more likely to transect tumors than excisional biopsies. The transection of melanoma did not affect overall disease-free survival or mortality in the population studied.
authors.affiliation: Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Mohsin
authors.initials: M
authors.lastname: Mir
authors.forename: C Stanley
authors.initials: CS
authors.lastname: Chan
authors.forename: Farhan
authors.initials: F
authors.lastname: Khan
authors.forename: Bhuvaneswari
authors.initials: B
authors.lastname: Krishnan
authors.forename: Ida
authors.initials: I
authors.lastname: Orengo
authors.forename: Theodore
authors.initials: T
authors.lastname: Rosen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods*; D001707:Biopsy, Needle / Q000379:methods; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate