title: Mitotic rate for thin melanomas: should a single mitotic figure warrant a sentinel lymph node biopsy?
abstract: BACKGROUND
  The seventh edition of the American Joint Committee on Cancer guidelines recognize mitotic rate (MR) as a component of the staging criteria for cutaneous melanomas with a Breslow depth ≤1 mm.
  
  
  OBJECTIVE
  This review discusses the evidence behind the threshold of 1 mitosis per square millimeter as a prognostic variable in thin melanomas, particularly because it relates to the decision to pursue a sentinel lymph node biopsy (SLNB).
  
  
  METHODS
  We performed a systematic review using the PubMed database to identify articles that contain prognostic information for thin melanomas based on MR and sentinel lymph node (SLN) status.
  
  
  RESULTS
  Although the threshold of a single mitosis correlates with a statistically significant decrease in survival rates for patients with thin melanomas, the clinical relevance remains questionable particularly because it relates to the decision to pursue an SLNB.
  
  
  CONCLUSIONS
  A single mitosis in thin melanomas does not increase the risk of a positive SLN so much that SLN biopsy should be routinely performed for this cohort.
authors: *Both the authors are affiliated with Shadyside Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: E Brent
authors: EB
authors: Kirkland
authors: John A
authors: JA
authors: Zitelli
mesh_terms: D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000235:genetics / Q000473:pathology* / Q000556:secondary; D008940:Mitotic Index; D018579:Patient Selection; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology*