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General Surgery · Skin: melanoma prognosis
Sample itemAfter excision biopsy of a pigmented lesion, which histological feature is the most important prognostic factor in localised melanoma?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Breslow thickness
Breslow thickness, measured in millimetres from the granular layer to the deepest tumour cell, is the strongest predictor of outcome in localised disease. Ulceration, mitotic rate and sentinel node status also matter. Clark level is less reliable.
Option by option
A. Size of the patient
Patient size is irrelevant.
B. Site of the biopsy
Biopsy site is not the main determinant.
C. Breslow thickness (correct)
Correct. Breslow thickness is the key prognostic factor.
D. Colour of the lesion
Colour is a clinical feature, not a prognostic measure.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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