title: Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age.
abstract: BACKGROUND
  Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women.
  
  
  OBJECTIVE
  This study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years.
  
  
  METHODS
  All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded.
  
  
  RESULTS
  A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger (P < .0008). Positive sentinel node status (P < .008), recurrence rates, metastatic disease (P < .001), and death rates (P < .008) were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence (P < .001), 7-fold increase in metastasis (P = .03) and 5-fold increase in mortality (P = .06).
  
  
  CONCLUSIONS
  This was a retrospective study.
  
  
  CONCLUSIONS
  The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.
authors.affiliation: Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Tellez
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Steven
authors.initials: S
authors.lastname: Rueda
authors.affiliation: Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ruzica Z
authors.initials: RZ
authors.lastname: Conic
authors.affiliation: Georgetown University School of Medicine, Washington, District of Columbia.
authors.forename: Kristin
authors.initials: K
authors.lastname: Powers
authors.affiliation: Department of Plastic Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Izabela
authors.initials: I
authors.lastname: Galdyn
authors.affiliation: Department of Dermatology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Natasha Atanaskova
authors.initials: NA
authors.lastname: Mesinkovska
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address: gastmab@ccf.org.
authors.forename: Brian
authors.initials: B
authors.lastname: Gastman
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: melanoma; outcomes; pregnancy; pregnancy-associated melanoma; sentinel node; survival; young