For melanoma, which of the following best describes the recommended surgical margin around the lesion according to AAD guidelines?

For melanoma, which of the following best describes the recommended surgical margin around the lesion according to AAD guidelines?

• A. Excision with narrow margins of 1-3 mm
• B. Wide margins of 2-5 cm
• C. Incisional biopsy only
• D. Mohs micrographic surgery

Answer: (A)

Surgical margins for melanoma are based on how deep the tumor has invaded (Breslow thickness) to ensure complete removal and minimize recurrence. After confirming melanoma, you don’t just remove a small peripheral strip; you perform a wide local excision with margins sized to the depth of invasion. For invasive melanoma, margins increase with thickness. Very thin tumors generally require about 1 cm of normal tissue around the lesion, while intermediate-depth tumors typically need 1–2 cm, and thicker tumors usually require about 2 cm. Melanoma in situ is treated with a smaller margin, around 0.5 cm. In any case, margins are not as narrow as 1–3 mm, and margins of 2–5 cm are not routinely necessary (2 cm is the common upper boundary for most cases). Incisional biopsy only does not treat the tumor; Mohs surgery is not the standard approach for melanoma in most settings, though certain specialized cases and centers may consider specific techniques. The key concept is wide local excision with margins chosen according to depth to achieve complete tumor removal.

Surgical margins for melanoma are based on how deep the tumor has invaded (Breslow thickness) to ensure complete removal and minimize recurrence. After confirming melanoma, you don’t just remove a small peripheral strip; you perform a wide local excision with margins sized to the depth of invasion.

For invasive melanoma, margins increase with thickness. Very thin tumors generally require about 1 cm of normal tissue around the lesion, while intermediate-depth tumors typically need 1–2 cm, and thicker tumors usually require about 2 cm. Melanoma in situ is treated with a smaller margin, around 0.5 cm. In any case, margins are not as narrow as 1–3 mm, and margins of 2–5 cm are not routinely necessary (2 cm is the common upper boundary for most cases).

Incisional biopsy only does not treat the tumor; Mohs surgery is not the standard approach for melanoma in most settings, though certain specialized cases and centers may consider specific techniques. The key concept is wide local excision with margins chosen according to depth to achieve complete tumor removal.