Miller J M, Slater D N
Department of Public Health, Trent Regional Health Authority, Sheffield.
J Clin Pathol. 1996 Mar;49(3):202-4. doi: 10.1136/jcp.49.3.202.
To audit the content of primary cutaneous malignant melanoma histopathology reports with special reference to Breslow thickness and lateral excision margins.
The Trent Regional Cancer Registry was asked to provide details of primary cutaneous malignant melanomas for the most recent year available (1990). Histopathology departments were then requested to provide copies of the relevant reports, which were then analysed.
In total, 178 reports were obtained from 16 departments. Breslow thickness was present in 87.1% (155/178) and a comment had been made on lateral excision in 85.4% (152/178). A specific clearance measurement was recorded in 5.6% (10/178), and in 9.6% (17/178) tumour was stated to extend to the margin. In 4.5% (8/178) neither thickness nor a comment on excision was recorded. Clinical advice on excision was offered in 12.4% (22/178). A macroscopic description was absent in 6.7% (12/178).
Deficiencies were identified in the quality of malignant melanoma histopathology reports in Trent Region. There is no reason to believe that significant improvements have occurred since 1990 or that other regions are performing differently. A national standard for reporting primary cutaneous malignant melanoma is recommended. As a minimum, all reports should include Breslow thickness and a specific measurement of lateral clearance. This will facilitate prognostic evaluation, clinical management and audit. This standard would not exclude the reporting of other information, depending on local policy. As with all standards, continual review must be undertaken and consideration given as to whether other more recent parameters, such as growth phase, also warrant future inclusion.
审核原发性皮肤恶性黑色素瘤组织病理学报告的内容，特别关注 Breslow 厚度和外侧切缘。
特伦特地区癌症登记处被要求提供可获取的最近一年（1990 年）原发性皮肤恶性黑色素瘤的详细信息。随后要求组织病理学科室提供相关报告的副本，并进行分析。
共从 16 个科室获得 178 份报告。87.1%（155/178）的报告中有 Breslow 厚度，85.4%（152/178）的报告对外侧切除进行了注释。5.6%（10/178）记录了具体的切缘清除测量值，9.6%（17/178）表明肿瘤延伸至切缘。4.5%（8/178）的报告既未记录厚度也未对切除进行注释。12.4%（22/178）的报告提供了关于切除的临床建议。6.7%（12/178）的报告没有宏观描述。
特伦特地区恶性黑色素瘤组织病理学报告的质量存在缺陷。没有理由相信自 1990 年以来有显著改善，也没有理由认为其他地区情况不同。建议制定原发性皮肤恶性黑色素瘤报告的国家标准。至少，所有报告应包括 Breslow 厚度和外侧切缘清除的具体测量值。这将有助于预后评估、临床管理和审核。根据当地政策，该标准不排除报告其他信息。与所有标准一样，必须持续进行审查，并考虑其他更新的参数（如生长阶段）是否也值得在未来纳入。
