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Effect of biopsy on the prognosis of melanoma

Ruthless surgery in black cutaneous lesions leads to increased morbidity and mutilation. Only 2 percent of such black tumors are melanomatous. Clinical diagnosis is difficult and often erroneous. Investigations by others indicate that partial removal of nevi does not result in malignant transformation. Longevity in patients with true melanoma is not decreased by incomplete biopsy procedures followed by definitive, hopefully curative surgery even 1 week later. Seemingly, the prognosis is improved by prophylactic lymph node dissection, but since the herein reported study was conducted on localized melanomas only, it is possible that the apparent improved outlook resulted from the elimination of patients with microscopic metastases from this series. Therefore, the ideal amount of tissue to be removed in attacking an undiagnosed black neoplasm is the amount necessary to establish a histopathologic diagnosis.