Case Study

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.

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