The International Collaboration on Cancer Reporting (ICCR) has released a paper in the American Journal of Surgical Pathology with recommendations to help establish more uniform reporting of invasive melanomas, so that the pathology reports that patients and clinicians receive have the elements that are clinically important.
The article can be freely downloaded at this link: http://journals.lww.com/ajsp/Fulltext/2013/12000/Data_Set_for_Pathology_Reporting_of_Cutaneous.3.aspx
One comment from this article refers to molecular pathology mutation testing for BRAF, NRAS, and KIT on primary melanomas:
“With the recent development and testing of new promising targeted therapies for patients with metastatic melanoma, molecular pathology mutation testing for BRAF, NRAS, KIT, and other mutations has become common in many melanoma treatment centers. At the present time, routine mutation testing is recommended only in patients with inoperable AJCC stage III or stage IV disease (and will therefore usually not be performed at the time of diagnosis of primary cutaneous melanoma), and mutation testing was not included in the current version of the ICCR melanoma pathology reporting protocol.”
Our dermatopathologists agree with this statement and, at this time, we consider it unnecessary to perform these tests routinely on all patients with a primary melanoma. It may not provide clinically relevant information to patients and clinicians regarding their primary melanoma, and results in an increased charge to the patient.
The article is an excellent read for those interested in pathology reporting of melanoma. If you have specific questions or concerns, please contact one of our Board Certified Dermatopathologists at 865-474-8866.