Can this patient avoid high-intensity treatment?
A 70-year-old male presented with malignant melanoma on his lateral left calf. With current guidelines, he was recommended to have a sentinel lymph node biopsy (SLNB) performed.
Case details
- Malignant melanoma
- 1.5 mm Breslow thickness
- No ulceration
- Mitotic rate: 3-4/mm2
- 1x1.4 cm pigment at one edge
- Stage: pT2a
Based on AJCC staging and NCCN guidelines
DecisionDx-Melanoma was immediately ordered after diagnosis because of the workflow implemented in the physician’s practice.
Why DecisionDx-Melanoma?
Based on published data, the physician implemented a policy in her practice to order DecisionDx-Melanoma on any patient with a Breslow’s thickness over 0.3 mm in patients 65 and older.
Test result and impact to care
DecisionDx-Melanoma test result of Class 1A indicated the lowest risk. The patient had a wide local excision performed and did not have a SLNB. The dermatologist followed the patient in her clinic and did not conduct any additional imaging.
The dermatologist continues to see the patient on a quarterly basis, and at two years out the patient has had no events.
By incorporating the Class 1A result, the patient was placed on a lower-intensity treatment plan.
