Melanoma
Spotting melanoma, biopsy and staging by Breslow thickness, margins and sentinel node biopsy, then adjuvant, neoadjuvant and metastatic immunotherapy and BRAF/MEK therapy.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Australia and New Zealand have the highest melanoma incidence in the world. It is the commonest cancer in Australians aged 15 to 29, and causes most of the roughly 2,000 skin cancer deaths a year.
- Breslow thickness drives prognosis, margins, sentinel node biopsy and follow-up. Get it right with an excision biopsy.
- Effective systemic therapy has moved upstream. Checkpoint inhibitors and BRAF/MEK inhibitors are now used after surgery (adjuvant), before surgery (neoadjuvant) and for metastatic disease.
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Sources
- Clinical practice guidelines for the diagnosis and management of melanomaAU/NZCancer Council Australia and Melanoma Institute Australia, Wiki guideline 2018 to 2020 chapters; staged revision under way, first 13 chapters through public consultation (checked November 2026)
- eviQ cancer treatments, melanoma protocolsAU/NZCancer Institute NSW, current protocols (checked November 2026)
- National targeted skin cancer screening to be accelerated with $10.3 million investmentAU/NZAustralian Government Department of Health and Aged Care, October 2024
- Roadmap for a targeted melanoma screening programAU/NZMelanoma Institute Australia, 4-year program from March 2025 (checked November 2026)
- Melanoma (margin and sentinel node tables, Australian 2018 and New Zealand 2013 guidelines)DermNet, checked November 2026
- PBS Schedule: ipilimumab (Yervoy), item 2638W, stage III melanomaAU/NZAustralian Government Department of Health, Disability and Ageing, checked November 2026
- NCCN Clinical Practice Guidelines in Oncology, Melanoma: CutaneousNational Comprehensive Cancer Network, 2026 (version number not verified)
- ESMO Clinical Practice Guidelines, cutaneous melanomaEuropean Society for Medical Oncology, 2019 guideline with eUpdates (latest version not verified)
- Gershenwald JE et al. Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:472-92CA: A Cancer Journal for Clinicians, 2017
- Blank CU et al. Neoadjuvant nivolumab and ipilimumab in resectable stage III melanoma (NADINA). N Engl J Med 2024;391:1696-708New England Journal of Medicine, 2024
- Patel SP et al. Neoadjuvant-adjuvant or adjuvant-only pembrolizumab in advanced melanoma (SWOG S1801). N Engl J Med 2023;388:813-23New England Journal of Medicine, 2023
- Faries MB et al. Completion dissection or observation for sentinel-node metastasis in melanoma (MSLT-II). N Engl J Med 2017;376:2211-22New England Journal of Medicine, 2017
- AJCC Cancer Staging Manual, 8th edition (melanoma of the skin)American Joint Committee on Cancer, 8th edition, in use since 2018 (no 9th edition melanoma chapter found, November 2026)
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy