Evaluation of dermoscopic features for distinguishing melanoma from special site nevi of the breast.
BACKGROUND
Nevi of special sites display aberrant clinical and histologic features that can be difficult to distinguish from melanoma, leading to unnecessarily high rates of excision with poor cosmetic or functional results. Dermoscopy can improve clinical assessment of melanocytic lesions by visualizing morphologic structures beyond the epidermis.


OBJECTIVE
We sought to assess the value of specific dermoscopic features for diagnosing melanocytic neoplasms arising on the breast area in females.


METHODS
In this retrospective cohort study, we collected clinical and dermoscopic information for 104 nevi and 13 melanomas removed from the breast, chest, and areola, and evaluated the diagnostic performance of each dermoscopic feature.


RESULTS
Melanomas from the breast area were larger (P = .0175) than nevi and occurred in older women (P = .0117). Irregular blotches, nonuniform radial streaks, blue-gray veil, and regression were highly specific for melanoma, whereas atypical network and irregular dots and globules had low to moderate specificity.


CONCLUSIONS
This study was retrospective with a small sample size.


CONCLUSIONS
Compared to melanocytic neoplasms from other sites, atypical network and irregular dots and globules were poor indicators for breast melanoma. Irregular blotches, nonuniform radial streaks, blue-gray veil, and regression were highly specific and should heighten clinical suspicion for melanoma arising on the breast.
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Emily A
EA
Merkel
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Mary C
MC
Martini
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Sapna M
SM
Amin
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Christina Y
CY
Lee
Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: pgerami1@nm.org.
Pedram
P
Gerami
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D046169:Dermoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009506:Nevus / Q000473:pathology*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D055815:Young Adult
breast; dermatopathology; dermoscopy; malignant melanoma; nevi of special sites; pattern analysis