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Melanoma Mole Checks

Melanoma moles are the most serious type of skin cancer moles. If picked up early, Melanoma Skin Cancer Treatment is very successful.

Early diagnosis is vital to prevent the spread and early treatment of Melanoma skin cancer. If you have a changing mole, or a bleeding mole with or without a hole in the mole, or a skin bump which is changing in colour or shape, or have fair skin problems including being sun burnt easily and sun induced cancer personally or in the family you should have your moles checked.

What is Malignant Melanoma Mole?

Melanoma is a common skin cancer prevalent mainly in fair skinned individuals who sun burn easily, been exposed to sun in the past with blistering sun burns history, family history of melanomas to name a few. It is a common cancer in New Zealand.

How do we diagnose malignant melanoma moles?

Melanomas are diagnosed either;

• by using clinical criteria like ABCDE (A -asymmetry, B- irregular border, C- 2 or more colours, D- more than 4 mm in diameter, E - evolution which means a history of change in the mole - could be itching, bleeding, darkening, enlarging, crusting, ulcerating)
• or by using a dermoscope.

Dermoscope is being increasingly used by GP's to diagnose melanomas. It needs special training and many years of experience to master the technique. It is a skin surface microscope which uses polarising light. By studying the pattern of the mole the dermoscopist can tell whether the mole is benign or cancer. Dermoscope can be attached to a camera for taking high quality magnified images ( like taking pictures of the surface of the moon ). These pictures can by used to evaluate the mole in a bigger screen or to consult with a fellow dermoscopist if it is a difficult mole (Teledermatology). This is the same technique that places like molemap and molecheck use.

What is the treatment of malignant melanoma moles?

The only treatment of a suspected melanoma is surgical excision ( cutting the mole out under local anaesthesia). The mole is analysed and depending upon the depth ( see below ) it needs a wider excision ( a bigger cut to take a bit more of the skin and fat).

What is my prognosis if diagnosed with malignant melanoma mole?

To determine the specific stage of a melanoma, there are two common diagnostic indicators:

BRESLOW THICKNESS

The Breslow thickness of the melanoma is a better melanoma stage diagnostic indicator than the Clark’s level; it is a continuous variable and more accurate in its determinations.

The Breslow thickness is a measure (in millimetres) of the vertical depth of the tumour measured from the granular cell (very top) layer downward. An instrument called an Ocular Micrometer is used to measure the thickness of the excised tumour.

Tumour thickness remains the most powerful prognostic indicator that can be determined from evaluation of the primary melanoma itself. Because of the accuracy of determining outcomes, the Breslow thickness is commonly included in a melanoma diagnosis.

Breslow Thickness and Survival Rate:

• less than 1mm: 5-year survival is 95-100%
• 1-2mm: 5-year survival is 80-96%
• 2.1-4mm: 5-year survival is 60-75%
• more than 4mm: 5-year survival is 37-50%

CLARK’S LEVEL

The Clark’s level is commonly misunderstood as the melanoma stage diagnosis. The Clark’s level only refers to how deep the tumour has penetrated into the skin. Research has shown that the Clark’s level diagnosis is not a great predictor of outcome.

• Clark's Level I - Confined to epidermis – also called “in situ” melanoma
• Clark's Level II - Invasion of the papillary dermis (upper)
• Clark's Level III - Filling of the papillary dermis (lower)
• Clark's Level IV - Extending into the reticular dermis
• Clark's Level V - Invasion of the subcutaneous tissue

Malignant Melanoma Mole Pictures

Mole removal