The Melanoma Pathology Report: What to Expect and How to Interpret It

Pathological information is critical to patient management in melanoma. A uniform approach based on current evidence is crucial and is summarized in this paper. Essential clinical and pathological parameters to report are the BAUSSS biomarker prognostic criteria, that is, Breslow thickness, patient age, presence of ulceration, melanoma subtype, patient sex, and anatomic site. Other important parameters to include are adnexal and periadnexal extension, tumor infiltrating lymphocytes, intravascular and abluminal lymphovascular invasion, microsatellites, in-transit metastases, perineural invasion, and margins. Additional parameters that have been recommended for inclusion are mitotic activity, regression, association with nevi and atypical melanocytic hyperplasia. The significance of special stains and genetic studies is also discussed.