NCCN Guidelines for Patients® | Melanoma - page 56

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
54
5.2
Treatment guide
In situ and local melanoma
5.2 In situ and local melanoma
Part 5.2 describes the tests and treatments that are
recommended for in situ and local melanoma. In situ
melanoma—stage 0—is when melanoma cells are
only in the outer layer of the skin (epidermis). Local
melanoma includes stages I and II. Local melanoma
tumors have grown into both skin layers—the
epidermis and dermis, the second layer of skin. But,
these melanomas haven’t spread anywhere beyond
the skin. (See Part 3 on page 26 for more details on
the stages of melanoma.)
Chart 5.2.1
shows the initial tests that are
recommended for in situ and local melanoma, which
includes stages 0, I, and II. The clinical stage is a
rating of the extent of melanoma in your body based
on tests done before surgery.
A few tests are recommended for all in situ and
local melanoma tumors.
These include a medical
history and physical exam. Imaging tests—tests that
take pictures of the inside of the body—are only
recommended if you have a specific sign or symptom
that your doctor needs to check. (Read page 21 for
imaging test details.) Routine imaging and blood tests
are not recommended in the absence of specific signs
or symptoms.
For stage II and some thicker stage IA and IB
melanoma tumors,
it may be more likely that cancer
cells have spread to lymph nodes based on certain
risk factors. Therefore, your doctor may talk to you
about having a surgical test called a sentinel lymph
node biopsy.
Clinical stage
Tests
Stage 0
(in situ)
• Medical history,
• Physical exam, and
• Imaging tests (CT, PET/CT, MRI)
for specific signs or symptoms
Chart 5.2.1 Tests for in situ and local melanoma
Stage IA or IB
(<0.75 mm thick)
• Medical history,
• Physical exam, and
• Imaging tests (CT, PET/CT, MRI)
for specific signs or symptoms
Stage IA
(0.76–1 mm thick)
Stage IB
(0.76–1 mm thick)
Stage II
• Medical history,
• Physical exam,
• Imaging tests (CT, PET/CT, MRI) for
specific signs or symptoms, and
• Possible sentinel lymph node biopsy
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