The surgical excision margin for a primary cutaneous melanoma with Breslow thickness of 2.5 mm (T3a) according to current guidelines should be:

• A 0.5 cm margin
• B 2 cm margin ✓
• C 1 cm margin
• D 3 cm margin

Explanation

Current guidelines (AJCC, British Association of Dermatology) recommend excision margins based on Breslow thickness: in-situ — 0.5 cm; up to 1 mm — 1 cm; 1.01-2 mm — 1-2 cm; >2 mm (including 2.5 mm, T3a) — 2 cm. A Breslow thickness of 2.5 mm falls in the >2 mm category requiring a 2 cm margin. Margins greater than 2 cm do not improve survival. For very thick melanomas (>4 mm), 2-3 cm is sometimes recommended but 2 cm is the standard minimum. Sentinel lymph node biopsy is recommended for tumors >1 mm.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.