MANAGEMENT OF CUTANEOUS MALIGNANT-MELANOMA BY DERMATOLOGISTS OF THE AMERICAN-ACADEMY-OF-DERMATOLOGY .1. SURVEY OF BIOPSY PRACTICES OF PIGMENTED LESIONS SUSPECTED AS MELANOMA

Background: The incidence of malignant melanoma (MM) has rapidly incre ased during the past five decades. Relatively little information is av ailable on whether the role of the dermatologist has increased concomi tantly in the surgical management of this cancer. Objective: Our purpo se was to learn how members of the American Academy of Dermatology (AA D) treat patients with lesions highly suspected as being MM and how th e management of these patients may have changed over the past decade. This, the first of a two-part series, concerns biopsies. Methods: The data for the study were collected by means of a questionnaire that was sent to all members of the AAD practicing in the United States (N = 7 412). Results: A total of 2991 valid questionnaires were returned, a r esponse rate of 40%. The majority of respondents (89% in 1982; 90% in 1992) stated that they performed the biopsies of pigmented lesions sus pected of being MMs. Excisional biopsy was the preferred technique (58 % in 1982; 68% in 1992). The type of biopsy and who performed the init ial biopsy of a suspected MM were associated with the following factor s: (1) the number of years in practice, (2) the type of practice, and (3) whether the dermatologist subsequently performed the definitive su rgery for the MM. Regional variations in biopsy practices were also no ted. Conclusion: Most AAD dermatologists who responded to the question naire perform the biopsies of lesions highly suspected of being MM. Du ring the last decade an increasing proportion of dermatologists are pe rforming excisional biopsies rather than other types of biopsies for s uch lesions.