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Text
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URL Address
<a href="http://doi.org/10.1097/DAD.0b013e31823347cb" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/DAD.0b013e31823347cb</a>
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Pages
737-745
Issue
7
Volume
34
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Title
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The Art and Science of Surgical Margins for the Dermatopathologist
Publisher
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American Journal of Dermatopathology
Date
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2012
2012-10
Subject
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basal cell carcinoma; basal cell carcinoma; cutaneous melanoma; Dermatology; excision; field cells; lentigo maligna melanoma; local recurrence; margins; neurotropic melanoma; perineural invasion; primary cutaneous melanoma; prognostic-factors; skin cancer; squamous cell carcinoma; staged excision; surgical; tumor-cells
Creator
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Weinstein M C; Brodell R T; Bordeaux J; Honda K
Description
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Basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and primary cutaneous melanoma (PCM) are the major forms of skin cancer. Surgical excision is one of the most frequently utilized treatment modalities for these tumors. Methods: literature review. Results: recommendations for lateral surgical excision margin (LEM) for BCCs is 4 mm for low-risk BCCs and Mohs surgery or resection with complete circumferential peripheral and deep margin assessment for high risk. Recommended LEM is 4-6 mm for low-risk SCCs and Mohs surgery or resection with complete circumferential peripheral and deep margin assessment for high risk BCCs. If SCC or BCC is >20 mm in area L with no other high-risk factors and can be repaired primarily, 10-mm clinical margins may be used. Recommended LEM is 5 mm for melanoma-in-situ; 1 cm for PCM <1 mm (Breslow); 1-2 cm for PCM 1.01-2 mm (Breslow); and, 2-3 cm for high-risk PCM >2.01 mm (Breslow). Tumor subtype-specific recommendations for histologic margins are offered which provide the greatest degree of certainty regarding the completeness of excision. Conclusion: Recommendations can be made regarding appropriate surgical excision margins by classifying skin cancers as low-risk or high-risk based on histopathological and clinical factors. Ascertaining that histopathologic margins are free of tumor is not a perfect science and requires thoughtful sampling, grossing, and staining procedures.
Identifier
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<a href="http://doi.org/10.1097/DAD.0b013e31823347cb" target="_blank" rel="noreferrer noopener">10.1097/DAD.0b013e31823347cb</a>
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Journal Article
2012
American Journal of Dermatopathology
basal cell carcinoma
Bordeaux J
Brodell R T
cutaneous melanoma
Dermatology
excision
field cells
Honda K
Journal Article
lentigo maligna melanoma
local recurrence
margins
neurotropic melanoma
perineural invasion
primary cutaneous melanoma
prognostic-factors
skin cancer
Squamous cell carcinoma
staged excision
Surgical
tumor-cells
Weinstein M C