Early thin melanomas, also known as “in situ” (stage 0) or stage I melanomas, are the earliest and most treatable forms of melanoma.
- Location: Confined to the outermost skin layer (epidermis) or have only minimally invaded the dermis.
- Size: Typically, less than 0.7–1.0 mm in thickness, as determined by the Breslow depth.
- Early Detection is Key: Prognosis is excellent when diagnosed and treated promptly.
Appearance: Often present as new or changing moles and can be identified using the ABCDEs of melanoma:
- A – Asymmetry (one half does not match the other).
- B – Border irregularity (uneven, scalloped, or blurred edges).
- C – Colour variation (multiple colours within the same mole).
- D – Diameter (greater than 6mm, though melanomas can be smaller).
- E – Evolution (changes in size, shape, colour, or new symptoms like itching or bleeding).
- Metastasis Risk: Low, but complete removal is essential to prevent progression.
Management of Early Thin Melanomas
- Surgical Excision
- Primary treatment for early thin melanomas.
- The melanoma is surgically removed with a margin of surrounding healthy tissue to ensure all cancerous cells are eliminated.
- Goal
- Achieve clear margins (no cancer cells at the edges of the removed tissue), significantly reducing recurrence risk.
- Recommended margins
- Melanoma in situ 0.5–1.0 cm margin.
- Stage I melanoma 1.0 cm margin, including underlying subcutaneous fat.
- Procedure details
- Performed under local anaesthesia.
- Can be done at KDAA or in a day surgery setting.
Importance of Surveillance and Follow-Up
Even after successful removal, ongoing monitoring is crucial as patients with one melanoma are at an increased risk of developing additional melanomas.
Follow-Up Care
- Regular dermatologist check-ups to detect any new or recurrent melanomas.
- Follow-up frequency depends on individual risk factors:
- Family history of melanoma.
- Number of atypical moles.
- Extent of past sun exposure and history of sunburns.
- Self-examinations:
Patients should routinely check their skin for new or changing moles. - Education on early melanoma detection is key.
- See” When Should I Get My Mole Assessed Urgently for Melanoma?” for more details.
Sun Protection Measures
- Daily use of broad-spectrum sunscreen (SPF 50+).
- Wearing protective clothing, including hats and sunglasses.
- Avoiding peak UV radiation exposure (10 AM–4 PM).
- Avoiding tanning beds, which significantly increase melanoma risk.
Prognosis and Long-Term Considerations
- Survival Rate: Over 95% 5-year survival rate for stage 0 and stage I melanomas, reflecting the effectiveness of early treatment.
- Future Skin Cancer Risk:Higher likelihood of developing new melanomas or other skin cancers.
Risk factors include:
- Fair skin.
- History of sunburns.
- Family history of melanoma.
Long-Term Care Focus:
- Monitoring and early detection to catch new skin cancers early.
- Preventative care to minimise UV damage and reduce future risks.
Advanced Care for Higher-Risk Melanomas
For thicker, higher-risk melanomas, KDAA collaborates with:
- Melanoma Institute of Australia.
- South Eastern Sydney Local Health District (SESLHD) Melanoma Multidisciplinary Team (St George and Sutherland Hospitals).
- Access to clinical trials and advanced treatments, ensuring expert care for complex cases.
Key Take Aways
- Early thin melanomas are highly treatable when detected and managed promptly.
- Surgical excision is the cornerstone of treatment.
- Regular skin checks and sun protection are essential for long-term skin health.
- Ongoing vigilance and preventative care reduce the risk of recurrence or future melanomas.
For expert assessment and management of melanoma, schedule a consultation with our dermatology team at KDAA.
