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In most cases of melanoma, complete excisional biopsy is used to establish diagnosis and staging for prognosis and further management. Occasionally, partial excisional biopsies are done because the lesions are large or the suspicion of melanoma is low. In this prospective study, investigators followed 250 patients whose melanoma was diagnosed by incisional biopsy that removed less than half of the original lesion. Differences in lesion thickness between the incisional biopsy and the final, therapeutic excision were analyzed.
Mean melanoma thickness increased from 0.66 mm as indicated by partial incisional biopsy to 1.07 mm when determined by complete excision. In 21% of patients, the increase in actual Breslow depth resulted in an upstage; t…