title: A comparative study of proliferative activity and tumor stage of pregnancy-associated melanoma (PAM) and non-PAM in gestational age women.
abstract: BACKGROUND
  The influence of pregnancy on the development, progression, and prognosis of melanoma is controversial.
  
  
  OBJECTIVE
  We sought to compare clinical characteristics, histologic features, and proliferative activity in pregnancy-associated melanoma (PAM) and melanoma in nonpregnant women of reproductive age (non-PAM).
  
  
  METHODS
  In this retrospective cohort study, we reviewed medical records and pathology reports from women given a diagnosis of melanoma between 2006 and 2015. We also examined tumor proliferation rates using mitotic count and 2 immunohistochemical markers of proliferation, phosphohistone H3 and Ki-67.
  
  
  RESULTS
  In 50 PAM and 122 non-PAM cases, a diagnosis of melanoma in situ was associated with PAM. Among invasive melanomas, there was no difference in proliferative activity between groups. Pregnancy status was also not associated with age at diagnosis, tumor site, Breslow depth, Clark level, ulceration, or overall stage.
  
  
  CONCLUSIONS
  This was a retrospective study with a small sample size of mostly patients with early-stage melanoma.
  
  
  CONCLUSIONS
  In our study of primarily early-stage melanoma, pregnancy did not have a significant impact on tumor proliferation. Particularly for patients given a diagnosis of stage I melanoma who are undergoing close surveillance, a history of PAM should not outweigh traditional factors, such as advanced maternal age, in planning future pregnancies.
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Merkel
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Martini
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Sapna M
authors.initials: SM
authors.lastname: Amin
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Oriol
authors.initials: O
authors.lastname: Yélamos
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Christina Y
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Sholl
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Rademaker
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Joan
authors.initials: J
authors.lastname: Guitart
authors.affiliation: Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: pgerami1@nm.org.
authors.forename: Pedram
authors.initials: P
authors.lastname: Gerami
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D049109:Cell Proliferation; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology / Q000473:pathology*; D011256:Pregnancy Outcome; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology*; D018709:Statistics, Nonparametric; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma
keywords: Ki-67; immunohistochemistry; malignant melanoma; mitotic rate; phosphohistone H3; pregnancy