Susan M Swetter1,2, Alan C Geller3, Adina Coroiu4, Chelsea Moran5, Jessica A Davine3, Kyla Brophy6, Catherine Bergeron6, Hensin Tsao7,8, Annett Körner6. 1. Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center, Stanford, USA. 2. Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, USA. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 401 Park Drive, West Wing 4th floor, 403G, Boston, MA, 02215, USA. 4. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 401 Park Drive, West Wing 4th floor, 403G, Boston, MA, 02215, USA. acoroiu@hsph.harvard.edu. 5. Department of Psychology, University of Calgary, Calgary, Canada. 6. Department of Educational and Counselling Psychology, McGill University, Montreal, Canada. 7. Harvard Medical School, Boston, USA. 8. Department of Dermatology, Massachusetts General Hospital, Boston, USA.
Abstract
BACKGROUND: Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM. METHODS: We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis. RESULTS: We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, "dot-like" size, fast changes in shape and color observed over 2 weeks, elevation and texture or "puffiness" over 6-12 months, and the sensation that the mole "did not feel right". Early signs reported by both thin NM and thin SSM patients included round or oblong shape, "jagged" border, pink/red, brown/reddish or dark coloration, "elevated like a pimple" or "tiny bump", fast color darkening, diameter growth, and border irregularity, and mole feeling "really itchy". CONCLUSIONS: We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.
BACKGROUND: Nodular (NM) and superficial spreading melanoma (SSM) show different disease trajectories, with more rapid development in NM and fewer opportunities for early detection often resulting in worse outcomes. Our study described the patient-identified early signs of thin NM via comparisons to thin (≤ 2 mm) SSM and thick (> 2 mm) NM. METHODS: We conducted semi-structured interviews with NM and SSM patients and analyzed the data using thematic analysis. RESULTS: We enrolled 34 NM and 32 SSM patients. Melanoma early signs uniquely identified by patients with thin NM included white, blue or black coloration, "dot-like" size, fast changes in shape and color observed over 2 weeks, elevation and texture or "puffiness" over 6-12 months, and the sensation that the mole "did not feel right". Early signs reported by both thin NM and thin SSM patients included round or oblong shape, "jagged" border, pink/red, brown/reddish or dark coloration, "elevated like a pimple" or "tiny bump", fast color darkening, diameter growth, and border irregularity, and mole feeling "really itchy". CONCLUSIONS: We found evidence that early signs of NM can be self-identified, which has important implications for the earlier detection of this most aggressive type of melanoma by both health professionals and patients.
Authors: Jacqueline F Moreau; Martin A Weinstock; Alan C Geller; Daniel G Winger; Laura K Ferris Journal: Melanoma Res Date: 2014-04 Impact factor: 3.599
Authors: Mary K Tripp; Meg Watson; Sophie J Balk; Susan M Swetter; Jeffrey E Gershenwald Journal: CA Cancer J Clin Date: 2016-05-27 Impact factor: 508.702