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Case Study
Is there rationale for this frequency of imaging and follow-up?
A 63-year-old caucasian male presents with two NCCN high risk factors and one very high risk factor.
Case details
The patient's lesion, located on his right posterior scalp, was greater than 2 cm in size. The patient required multiple stages of Mohs surgery, and the lesion was found to have invaded beyond subcutaneous fat.
- Imaging surveillance of lymph nodes every 6 months
- Follow-up every 3 months
Why DecisionDx-SCC?
Due to the patient’s age, the clinician preferred to avoid radiation and sentinel lymph node biopsy (SLNB), and to do surveillance of the patient’s lymph nodes with imaging instead. However, the clinician was concerned with the patient having two NCCN high risk factors, along with a very high risk factor, and the DecisionDx-SCC GEP test was ordered to determine whether the clinician's desired management plan was appropriate.
Test result
In this patient, the DecisionDx-SCC test result of Class 2A indicates a higher biological risk for metastasis (38.6%). This assisted the clinician in deciding to proceed with the treatment pathway – imaging surveillance twice a year for two years with clinical follow-up every three months. 16 months post-treatment, the wound has healed with no sign of the disease present.
Based on the Class 2A DecisionDx-SCC test result, the indication of a higher risk of metastasis, and the patient’s age, the clinician determined that the pre-test rationale for post-surgical management with frequent surveillance was appropriate for the patient. Follow-up was scheduled for every three months, with imaging surveillance of lymph nodes twice a year for two years. 16 months post-treatment, the wound has healed with no evidence of recurrence or metastasis.
DecisionDx-SCC testing provided valuable objective information and helped determined that the pre-test rationale for post-surgical management with frequent surveillance was appropriate for the patient.
