Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Advertisement
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
Advertisement
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Life
    • eLetters
    • Librarian information
    • Alerts
    • Resilience
    • Video
    • Audio
    • COVID-19 Clinical Solutions
Letters

Diagnostic biopsy of melanoma: primary or secondary care?

M Mowbray and Jinah Yoo
British Journal of General Practice 2014; 64 (618): 14. DOI: https://doi.org/10.3399/bjgp14X676302
M Mowbray
Consultant Dermatologist, Queen Margaret Hospital, Dunfermline.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jinah Yoo
Dermatology Registrar, Lauriston Building, Edinburgh. E-mail:
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: Jinah.Yoo@nhslothian.scot.nhs.uk
  • Article
  • Info
  • eLetters
  • PDF
Loading

Murchie et al1 compared morbidity and mortality in patients who had initial diagnostic excision biopsy in primary versus secondary care. The Breslow thickness of a melanoma is the main prognostic indicator in the melanoma patients included in this study. The mean thickness in both the primary and secondary care groups was ≤1mm: such patients have a 95% 10-year survival rate,2 so that mortality and morbidity are not particularly relevant endpoints.

Suspected melanoma is best managed in secondary care because meeting a patient at their initial clinic visit and diagnostic biopsy allows a more informed discussion at the MDT, leading to better management, and if the melanoma is diagnosed in secondary care, we can ensure that ‘breaking of bad news’ is made by a clinician or skin cancer support nurse, who have the knowledge and experience to explain the prognostic significance of the melanoma, the MDT decisions and the further treatments required.

We have looked at patients who had GP melanoma excisions in our region. In 70% of cases no clinical diagnosis was given on the pathology form, which may affect the interpretation of the pathology and the speed with which the material is processed. To improve lesion recognition and management by GPs in our region, GPs are invited to sit in on our weekly rapid access tumour clinics. We also plan to distribute a bi-monthly presentation of ‘lesion pictures’ to all GPs. A ‘minor surgery interest group’ has been formed who will meet annually to improve lesion recognition and management and to promote regional skin cancer pathways and communication between GPs and the local skin cancer team. We advise that suspicious pigmented lesions are referred urgently to secondary care. We hope our education programme will improve the experience of the patient, the GP and the secondary care physician involved in management of skin cancer patients.

  • © British Journal of General Practice 2014

REFERENCES

  1. 1.↵
    1. Murchie P,
    2. Raja AE,
    3. Lee AJ,
    4. Campbell NC
    (2013) Mortality and morbidity after initial diagnostic excision biopsy of cutaneous melanoma in primary versus secondary care. Br J Gen Pract doi:10.3399/bjgp13X670697.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Balch CM,
    2. Gershenwald JE,
    3. Soong SJ,
    4. et al.
    (2009) 2009 AJCC Melanoma Classification and Staging. J Clin Oncol 27(36):6199–6206.
    OpenUrlAbstract/FREE Full Text
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 64 (618)
British Journal of General Practice
Vol. 64, Issue 618
January 2014
  • Table of Contents
  • Index by author
Download PDF
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Diagnostic biopsy of melanoma: primary or secondary care?
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Diagnostic biopsy of melanoma: primary or secondary care?
M Mowbray, Jinah Yoo
British Journal of General Practice 2014; 64 (618): 14. DOI: 10.3399/bjgp14X676302

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Diagnostic biopsy of melanoma: primary or secondary care?
M Mowbray, Jinah Yoo
British Journal of General Practice 2014; 64 (618): 14. DOI: 10.3399/bjgp14X676302
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • REFERENCES
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • Two-tiered medicine: the increasing disparity in medical care in the UK
  • MRCGP Recorded Consultation Assessment — the hidden fourth construct
  • Prostate-specific antigen testing and opportunistic prostate cancer screening — CAP intervention
Show more Letters

Related Articles

Cited By...

Advertisement

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7679
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2021 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242