NCCN Guidelines for Patients® | Melanoma - page 69

NCCN Guidelines for Patients
®
Melanoma, Version 1.2014
67
Chart 5.4.1
shows the recommended tests for
cancer that came back after treatment and is at or
near the site of the first (primary) melanoma. Read
Part 2 on page 16 for more details on the tests listed
in the chart.
For persistent melanoma or true local scar
recurrence,
the first recommended test is a skin
biopsy to confirm the diagnosis. A biopsy is the
removal of small amounts of tissue from your body
to test for disease. The next tests you will receive
are based on the stage and features of the primary
melanoma tumor.
For local, satellite, and/or in-transit recurrence,
the first recommended test is a biopsy to confirm
the diagnosis. Options include an FNA biopsy or
excisional biopsy. During the biopsy, your doctor may
remove another tissue sample for genetic testing
if you might join a clinical trial of targeted therapy.
(See page 38 for details.) Baseline imaging tests are
recommended for staging and to check out specific
signs or symptoms. A baseline is a starting point to
which future test results are compared.
For regional lymph node recurrence,
the first
recommended test is a biopsy of the enlarged lymph
nodes to confirm the diagnosis. An FNA biopsy is
preferred, but an excisional biopsy is another option.
Baseline imaging tests are recommended for staging
and to check out specific symptoms. A CT scan of
your pelvis is recommended if the regional lymph
node recurrence is in your groin.
Next steps:
For persistent melanoma or true local
scar recurrence, see Chart 5.2.1 for the
next tests that are recommended. For
node-negative recurrence, see Chart
5.4.2 for recommended treatments.
For regional lymph node recurrence,
see Chart 5.4.3 for recommended
treatments.  
5.4
Treatment guide
Persistent melanoma and nonmetastatic recurrence
1...,59,60,61,62,63,64,65,66,67,68 70,71,72,73,74,75,76,77,78,79,...108
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