title: Relationship between melanoma detection pattern and tumor thickness.
abstract: BACKGROUND
  Melanoma tumor thickness remains the most important determinant of patient survival. Several large population-based studies have shown that full-body skin examinations (FBSE) improve melanoma mortality and others that FBSEs may detect melanomas at a thinner, more curable stage.
  
  
  OBJECTIVE
  To relate the detection method to lesion thickness at the time of diagnosis.
  
  
  METHODS
  A retrospective chart review of all cases of biopsy-proven primary cutaneous melanomas diagnosed from 2000 to 2012 at the Veterans Affairs Hospital in Brooklyn NY was conducted. Data were collected in 2012-2013 and analyzed in 2013. Main outcome measures include lesion thickness stratified by method of detection and probabilities of detecting thin lesions per method (using cut-offs of in situ and 0.75 mm). Secondary outcomes include interaction between method and body site or lesion diameter.
  
  
  RESULTS
  Sixty-three percent of melanomas were detected by FBSE and 59% of all melanomas were in situ. There was no statistically significant difference in thickness among the detection groups when a cut-off of in situ (Fisher's exact test, p=0.6148) or 0.75 mm was used (p=0.8910). A majority of lesions on the back were found by FBSE (68%).
  
  
  CONCLUSIONS
  FBSE was not shown to detect melanomas at a thinner stage. Prospective studies are needed to analyze the utility and efficacy of FBSEs in clinical practice.
authors: Department of Dermatology, Downstate Medical Center, Brooklyn. Electronic address: williams.estee@gmail.com.
authors: Estee L
authors: EL
authors: Williams
authors: State University of New York, Downstate Medical Center, Brooklyn.
authors: Man Kin
authors: MK
authors: Derek Ho
authors: Department of Dermatology, Memorial Sloan-Kettering Cancer Center.
authors: Allan C
authors: AC
authors: Halpern
authors: Department of Dermatology, Mount Sinai Medical Center, New York, New York.
authors: Orit
authors: O
authors: Markowitz
authors: Department of Dermatology, Downstate Medical Center, Brooklyn.
authors: Daniel M
authors: DM
authors: Siegel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult