Clinical recommendationEvidence ratingReferences
Physicians may choose to screen patients with a total-body skin examination, especially those at higher risk (evidence insufficient to recommend for or against).C8
Suspicious lesions should undergo full thickness biopsy into the underlying subcutaneous tissue with a 1- to 2-mm border.C11
Shave biopsies should never be used if melanoma is suspected.C11
Surgical resection with wide margins (greater than 3 cm) no longer is recommended.A29,30
Recommended margins are 0.5 cm for melanoma in situ, 1 cm for melanomas with a Breslow thickness of 0.5 to 1 mm, and 2 cm for melanomas with a Breslow thickness greater than 1 mm.B2931
Nodal evaluation is recommended in patients with melanomas at least 1 mm in thickness. Sentinel lymph node biopsy is recommended in patients with intermediate thickness melanoma (1 to 4 mm) and clinically negative nodes.B33,37,38
Patients with melanoma need intensive follow-up, especially during the first two to three years after diagnosis.C41
Educational and policy changes in elementary schools and similar interventions for adults in recreational settings can increase sun-protective behaviors and are recommended.C5