Reduction in nevus biopsies in patients monitored by total body photography

Truong, Amanda; Strazzulla, Lauren C.; March, Jordon; Boucher, Kenneth M.; Nelson, Kelly C.; Kim, Caroline C.; Grossman, Douglas

doi:10.1016/j.jaad.2016.02.1152

Cited by 42 publications

(49 citation statements)

References 30 publications

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“…Although required for histopathology, biopsies have several limitations including potential adverse cosmetic and functional effects, cost, increased patient anxiety and decreased workplace productivity. Patient risk and anxiety and physician expertise influence the benign-to-malignant ratio ( 15 ), and the SCREEN study in Schleswig-Holstein, Germany, found that 20 to 55 excisions were performed to diagnose one melanoma ( 16 ).…”

Section: Advantages Of 3d Total Body Photography: Potential To Improvmentioning

confidence: 99%

Clinical Perspective of 3D Total Body Photography for Early Detection and Screening of Melanoma

et al. 2018

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Melanoma incidence continues to increase across many populations globally and there is significant mortality associated with advanced disease. However, if detected early, patients have a very promising prognosis. The methods that have been utilized for early detection include clinician and patient skin examinations, dermoscopy (static and sequential imaging), and total body photography via 2D imaging. Total body photography has recently witnessed an evolution from 2D imaging with the ability to now create a 3D representation of the patient linked with dermoscopy images of individual lesions. 3D total body photography is a particularly beneficial screening tool for patients at high risk due to their personal or family history or those with multiple dysplastic naevi—the latter can make monitoring especially difficult without the assistance of technology. In this perspective, we discuss clinical examples utilizing 3D total body photography, associated advantages and limitations, and future directions of the technology. The optimal system for melanoma screening should improve diagnostic accuracy, be time and cost efficient, and accessible to patients across all demographic and socioeconomic groups. 3D total body photography has the potential to address these criteria and, most importantly, optimize crucial early detection.

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Section: Advantages Of 3d Total Body Photography: Potential To Improvmentioning

confidence: 99%

Clinical Perspective of 3D Total Body Photography for Early Detection and Screening of Melanoma

et al. 2018

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“…Lack of change of a lesion during follow-up indicates benignancy because melanocytic nevi are very stable once they have reached the stage of senescence. Accordingly, follow-up of patients with myriad pigmented lesions through total body photography has resulted in a significant decrease of biopsy rates [ 60 ]. On the other hand, if a lesion shows changes during follow-up, this alone may prompt a biopsy to be performed— although less than 10% of changing lesions have been found to be melanomas [ 61 ].…”

Section: Increase In the Number Of Biopsiesmentioning

confidence: 99%

Screening for malignant melanoma—a critical assessment in historical perspective

Weyers

2018

Dermatol Pract Concept

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Screening for melanoma has been advocated for many years because early detection and excision have been regarded as the most important measure to lower mortality from that neoplasm. In the past decade, concern has been raised by epidemiologists that screening might result in excision chiefly of “inconsequential cancer,” i.e., melanomas that would never have progressed into life-threatening tumors, a phenomenon referred to by the misleading term “overdiagnosis.” Without any firm evidence, that speculation has been embraced worldwide, and incipient melanomas have been trivialized. At the same time, efforts at early detection of melanoma have continued and have resulted in biopsy of pigmented lesions at a progressively earlier stage, such as lesions with a diameter of only 2, 3, or 4 mm. Those tiny lesions often lack sufficient criteria for clinical and histopathologic diagnosis, the result being true overdiagnoses, i.e., misdiagnoses of melanocytic nevi as melanoma. This is especially true if available criteria for histopathologic diagnosis are diminuished even further by incomplete excision of lesions. The reliability of histopathologic diagnosis is far higher in excisional biopsies of lesions that were given some more time to develop changes that make them recognizable. Biopsy of pigmented lesions with a diameter of 6 mm has been found to result in a far higher yield of melanomas. In addition to better clinical judgment, slight postponement of biopsies bears the promise of substantial improvement of the reliability of histopathologic diagnosis, and of alleviating true overdiagnoses.

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“…Total body photography (TBP) has been associated with detection of thin melanomas, fewer biopsies and decreased patient anxiety . While detection of thinner melanomas is a surrogate for survival benefit, whether TBP is associated with improved survival has not been examined.…”

Section: Introductionmentioning

confidence: 99%

Improved melanoma outcomes and survival in patients monitored by total body photography: A natural experiment

Strunck

Smart

Boucher

et al. 2020

The Journal of Dermatology

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Total body photography (TBP) facilitates early melanoma detection, but long‐term outcomes have not been well studied. Our objectives were to examine melanoma diagnoses, role of TBP‐associated follow‐up visits, and survival in patients monitored by TBP. A total of 1955 patients meeting inclusion criteria received TBP from 2004–2013 at a single academic center. We compared the melanoma diagnoses and overall survival of 1253 patients with any follow‐up visits (median, three visits; range, 1–18) and 702 patients with no follow‐up visits. Use of TBP photographs influenced decision to biopsy 66 of 121 (54.5%) melanomas diagnosed after TBP. Lower invasive melanoma Breslow depth was significantly associated with having one or more follow‐up visit (median, 0.83 vs 0.33 mm; P = .002) and photographic review (median, 0.31 vs 0.48 mm; P = 0.02). In multivariable analyses, greater overall survival was significantly associated with having one or more follow‐up visit after TBP (hazard ratio [HR], 0.36; 95% confidence interval [CI], 0.14–0.91; P < 0.032) and having more than 100 nevi (HR, 0.37; 95% CI, 0.22–0.64; P = 0.004). Worse overall survival was significantly associated with increasing age (HR per year, 1.06; 95% CI, 1.04–1.08; P < 0.001) and male sex (HR, 2.65; 95% CI, 1.48–4.73; P = 0.001). Thus, monitoring by TBP was associated with subsequent melanoma diagnoses of lower stage and depth and greater overall survival.

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Reduction in nevus biopsies in patients monitored by total body photography

Cited by 42 publications

References 30 publications

Clinical Perspective of 3D Total Body Photography for Early Detection and Screening of Melanoma

Clinical Perspective of 3D Total Body Photography for Early Detection and Screening of Melanoma

Screening for malignant melanoma—a critical assessment in historical perspective

Improved melanoma outcomes and survival in patients monitored by total body photography: A natural experiment

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