Risk Keys

Clark’s level affects classification of T1 tumors only.

Melanoma in situ is Clark’s level 1.

T1a requires Clark’s level II or III.

T1b tumors warrant sentinel node biopsy at Clark’s level IV and V.

Predisposing factors for melanoma

Precursor lesions (atypical/dysplastic nevus, lentigo maligna)

Phenotype: light skin pigmentation, freckling, ease of developing sunburn, red or blond hair, blue eyes

Family history of melanoma

Personal history of melanoma

Sentinel node (the first lymph node to receive drainage from a tumor) mapping provides a minimally invasive way to detect nodal metastases and avoid radical lymphadenectomy.