Tuesday, February 9, 2016

Women and melanoma risk

Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age.  Tellez, Rueda, Conic, et al.  J Am Acad Dermatol. 2016 Jan 11.

“Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women.  This [retrospective] study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years.
All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded. A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger. Positive sentinel node status, recurrence rates, metastatic disease, and death rates  were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence, 7-fold increase in metastasis and 5-fold increase in mortality.
The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.”

This post covers several articles that looks at the odds for positive sentinel nodes and recurrences in folks with thin melanoma lesions - also noting being less than age 40 increases risk: With melanoma you can never be too rich or too thin! But, you can be too young! 

The article covered here indicates:  "the only clinicopathologic factors associated with longer Progression Free Survival (PFS) and OS were being female and a normal pretreatment serum lactate dehydrogenase (LDH) level."  Being female with low LDH and no ulceration in primary and BRAF V600 positive = increased survival rates with BRAFi 

And then there is this:  Melanoma risk significant among pregnant women

For what it's worth - c 

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