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breslow versus clarks

Forums General Melanoma Community breslow versus clarks

  • Post
    panda
    Participant

      Hi there, could someone pls explain to me the difference  between Clarks level and Breslow Level, i am a level II something? cant find my diagnosis, so it was either clarkes or breslow? hmmm. Sorry!. anyway, my mole was about an eighteenth of a millimetre deep on my back and it has b een removed with a two centimetre margin around it. Doctor says it looks great now and i have nothing to worry about, just to come back for check ups every five months . When i went back for my check up they just looked at my moles said i looked fine and that was it…

      Hi there, could someone pls explain to me the difference  between Clarks level and Breslow Level, i am a level II something? cant find my diagnosis, so it was either clarkes or breslow? hmmm. Sorry!. anyway, my mole was about an eighteenth of a millimetre deep on my back and it has b een removed with a two centimetre margin around it. Doctor says it looks great now and i have nothing to worry about, just to come back for check ups every five months . When i went back for my check up they just looked at my moles said i looked fine and that was it… For everyone who is very sick i am very sorry for you honestly, and my problem must look very minor, but im just wondering is there anything else i should be getting done?Thankyou.

    Viewing 8 reply threads
    • Replies
        lhaley
        Participant

          The Clark is no longer used in most pathology's.  The Breslow is actually given the depth. 

          Dr Wallace Clark was my original dermatologist at Univ of Pa.  Wonderful Dr where he originally had all of my paths were all reread many years ago in the 80's.   They have used a new chart that gives staging (stage 1, II, 3 or IV) . Some pathologists still mention the Clark scale but not given as much.

          When they tell you about the margin they are letting you know how wide of an excision they have cut. The 0.18 (if I am understanding what you are saying) is letting know you that yours is very thin and you discovered at a good place.  I'm just not sure why you are told as "deep on the back". 

          Look at your pathology report to see exactly how it's told. 

          Linda

          lhaley
          Participant

            The Clark is no longer used in most pathology's.  The Breslow is actually given the depth. 

            Dr Wallace Clark was my original dermatologist at Univ of Pa.  Wonderful Dr where he originally had all of my paths were all reread many years ago in the 80's.   They have used a new chart that gives staging (stage 1, II, 3 or IV) . Some pathologists still mention the Clark scale but not given as much.

            When they tell you about the margin they are letting you know how wide of an excision they have cut. The 0.18 (if I am understanding what you are saying) is letting know you that yours is very thin and you discovered at a good place.  I'm just not sure why you are told as "deep on the back". 

            Look at your pathology report to see exactly how it's told. 

            Linda

            lhaley
            Participant

              The Clark is no longer used in most pathology's.  The Breslow is actually given the depth. 

              Dr Wallace Clark was my original dermatologist at Univ of Pa.  Wonderful Dr where he originally had all of my paths were all reread many years ago in the 80's.   They have used a new chart that gives staging (stage 1, II, 3 or IV) . Some pathologists still mention the Clark scale but not given as much.

              When they tell you about the margin they are letting you know how wide of an excision they have cut. The 0.18 (if I am understanding what you are saying) is letting know you that yours is very thin and you discovered at a good place.  I'm just not sure why you are told as "deep on the back". 

              Look at your pathology report to see exactly how it's told. 

              Linda

              Janner
              Participant

                Clark's Level is the level of skin invaded.  Breslow depth is the depth, in millimeters, of the melanoma lesion.  Your original post you stated stage II, but it is most likely you are Clark's Level II with a Breslow depth of 0.18mm.  This is stage I.  Clark's Level is still called out – especially for thin lesions.  But Breslow depth is really the better prognostic factor.  Clark's Level has been found to be too subjective and Breslow is more accurate.  0.18mm is considered extremely thin and has a very good prognosis with surgery alone.

                If you go to my website linked below, you can click on the Newly Diagnosed button.  At the bottom of the links, there is a good description on what Clark's Level means and why it is often confused with stage.

                Periodic skin checks are really all you can do at this point.  Watch for any moles that CHANGE.  Practice sun safety.  See your derm regularly, and ENJOY LIFE!

                Best wishes,

                Janner

                Janner
                Participant

                  Clark's Level is the level of skin invaded.  Breslow depth is the depth, in millimeters, of the melanoma lesion.  Your original post you stated stage II, but it is most likely you are Clark's Level II with a Breslow depth of 0.18mm.  This is stage I.  Clark's Level is still called out – especially for thin lesions.  But Breslow depth is really the better prognostic factor.  Clark's Level has been found to be too subjective and Breslow is more accurate.  0.18mm is considered extremely thin and has a very good prognosis with surgery alone.

                  If you go to my website linked below, you can click on the Newly Diagnosed button.  At the bottom of the links, there is a good description on what Clark's Level means and why it is often confused with stage.

                  Periodic skin checks are really all you can do at this point.  Watch for any moles that CHANGE.  Practice sun safety.  See your derm regularly, and ENJOY LIFE!

                  Best wishes,

                  Janner

                  Janner
                  Participant

                    Clark's Level is the level of skin invaded.  Breslow depth is the depth, in millimeters, of the melanoma lesion.  Your original post you stated stage II, but it is most likely you are Clark's Level II with a Breslow depth of 0.18mm.  This is stage I.  Clark's Level is still called out – especially for thin lesions.  But Breslow depth is really the better prognostic factor.  Clark's Level has been found to be too subjective and Breslow is more accurate.  0.18mm is considered extremely thin and has a very good prognosis with surgery alone.

                    If you go to my website linked below, you can click on the Newly Diagnosed button.  At the bottom of the links, there is a good description on what Clark's Level means and why it is often confused with stage.

                    Periodic skin checks are really all you can do at this point.  Watch for any moles that CHANGE.  Practice sun safety.  See your derm regularly, and ENJOY LIFE!

                    Best wishes,

                    Janner

                      panda
                      Participant

                        Dear Janner, thankyou very much, i only just saw your reply to me now. AFTER i posted what i just posted then.. Thankyou, yes i was getting confused with LEVEL II and clarks level II as some peoples Level II sound quite bad, nowhere near as bad as i am. but i WAS told by the skin specialist that i am lucky it was caught at a very good time.  Thankyou for taking the time to reply to me and i will try and find this link you are talking about ok. thankyou. from Felicity.

                        panda
                        Participant

                          Dear Janner, thankyou very much, i only just saw your reply to me now. AFTER i posted what i just posted then.. Thankyou, yes i was getting confused with LEVEL II and clarks level II as some peoples Level II sound quite bad, nowhere near as bad as i am. but i WAS told by the skin specialist that i am lucky it was caught at a very good time.  Thankyou for taking the time to reply to me and i will try and find this link you are talking about ok. thankyou. from Felicity.

                          panda
                          Participant

                            Dear Janner, thankyou very much, i only just saw your reply to me now. AFTER i posted what i just posted then.. Thankyou, yes i was getting confused with LEVEL II and clarks level II as some peoples Level II sound quite bad, nowhere near as bad as i am. but i WAS told by the skin specialist that i am lucky it was caught at a very good time.  Thankyou for taking the time to reply to me and i will try and find this link you are talking about ok. thankyou. from Felicity.

                          panda
                          Participant

                            Hi, i am Panda, the person who posted this original message. OK. i went to the doctors and got mydiagnosis again, and here it is can SOMEONE pls tell me if ths is not very good. So many people i am reading, once they have had a melonama cut out, keep going back for tests and getting checks for lumps, mole changes etc which is logical. but can someone tell me IS STAGE II very bad???? i really dont know…. Is it the one that is half way to STAGE FOUR? my father passed away last year from stage Four… He had a melanoma removed two years earlier, it came back got into spine and he passed away. it was terrible. He was adopted and knows not about his family history, so i want and got checked and found out i hve this. can someone tell me how REGULARLY I SHOULD HAVE CHECK UPS PLS? and WHAT i shoudl get done AT THESE CHECK UPS? l have only been back for check up once since it was removed from my back with a two cm margin, and all they did was look at my moles and say everything looks ok and do i want a mole map

                            I AM going to get a mole map , are mole maps good?

                             

                            here is my diagnosis

                            Skin Lesion right back, appearance consistent with early invasive malignant melanoma, arising from a dysplastic naevus, BRESLOW thickness zero point twenty five mm clark level II, no perineural or lymphovascular invasion. nearest superior resection margin to invasive component, 3 point six mm and to dysplastic nerves 1.1 mm, distance from tumour to deep margin 4.4 mm wider excision recommended.

                             

                            I had this removed.

                             

                            WHAT NEXT, can someone tell me what they think of this diagnosis. are things looking ok for me, or is this a NEVER ENDING THING, that you just have to keep checking your body forever and ever. to make sure you are not getting more.

                             

                            Sounds really depressing

                            Thankyou. pls can someone tell me. thanks

                              Janner
                              Participant

                                YOU ARE NOT STAGE II.  You are Clark's Level II.  Not the same thing.  Read the link I sent you before.  You are stage I with a very low risk lesion.  Survival rate in the high 90's%.  You are not halfway to stage IV.  Your diagnosis even says early invasive malignant melanoma.

                                Your stats are:

                                Breslow 0.25mm, Clark Level II, no ulceration, no regression

                                This is stage IA or IB.  Your report doesn't mention mitosis and that detail determines the different between 1A and 1B.

                                Your checkups should consist of checking your moles for CHANGE.  You should also learn how to palpate your nearest lymph node basin.  Have your doctor show you how.  Mole mapping involves taking pictures of your existing moles so you can monitor them for change.  It's a good idea.  It takes the guess work out of wondering if something has changed or not.  Other than that, this is all that is basically done for a stage I individual.  There are no other appropriate tests.  Yes, this is a never ending thing – you don't stop checking your body in the future.  The key is to be vigilant, not paranoid.  There's really no difference in checking your moles for change and doing a monthly self breast exam.  You should do both on a monthly basis.  Then LIVE LIFE!

                                Best wishes,

                                Janner

                                Janner
                                Participant

                                  YOU ARE NOT STAGE II.  You are Clark's Level II.  Not the same thing.  Read the link I sent you before.  You are stage I with a very low risk lesion.  Survival rate in the high 90's%.  You are not halfway to stage IV.  Your diagnosis even says early invasive malignant melanoma.

                                  Your stats are:

                                  Breslow 0.25mm, Clark Level II, no ulceration, no regression

                                  This is stage IA or IB.  Your report doesn't mention mitosis and that detail determines the different between 1A and 1B.

                                  Your checkups should consist of checking your moles for CHANGE.  You should also learn how to palpate your nearest lymph node basin.  Have your doctor show you how.  Mole mapping involves taking pictures of your existing moles so you can monitor them for change.  It's a good idea.  It takes the guess work out of wondering if something has changed or not.  Other than that, this is all that is basically done for a stage I individual.  There are no other appropriate tests.  Yes, this is a never ending thing – you don't stop checking your body in the future.  The key is to be vigilant, not paranoid.  There's really no difference in checking your moles for change and doing a monthly self breast exam.  You should do both on a monthly basis.  Then LIVE LIFE!

                                  Best wishes,

                                  Janner

                                  Janner
                                  Participant

                                    YOU ARE NOT STAGE II.  You are Clark's Level II.  Not the same thing.  Read the link I sent you before.  You are stage I with a very low risk lesion.  Survival rate in the high 90's%.  You are not halfway to stage IV.  Your diagnosis even says early invasive malignant melanoma.

                                    Your stats are:

                                    Breslow 0.25mm, Clark Level II, no ulceration, no regression

                                    This is stage IA or IB.  Your report doesn't mention mitosis and that detail determines the different between 1A and 1B.

                                    Your checkups should consist of checking your moles for CHANGE.  You should also learn how to palpate your nearest lymph node basin.  Have your doctor show you how.  Mole mapping involves taking pictures of your existing moles so you can monitor them for change.  It's a good idea.  It takes the guess work out of wondering if something has changed or not.  Other than that, this is all that is basically done for a stage I individual.  There are no other appropriate tests.  Yes, this is a never ending thing – you don't stop checking your body in the future.  The key is to be vigilant, not paranoid.  There's really no difference in checking your moles for change and doing a monthly self breast exam.  You should do both on a monthly basis.  Then LIVE LIFE!

                                    Best wishes,

                                    Janner

                                  panda
                                  Participant

                                    Hi, i am Panda, the person who posted this original message. OK. i went to the doctors and got mydiagnosis again, and here it is can SOMEONE pls tell me if ths is not very good. So many people i am reading, once they have had a melonama cut out, keep going back for tests and getting checks for lumps, mole changes etc which is logical. but can someone tell me IS STAGE II very bad???? i really dont know…. Is it the one that is half way to STAGE FOUR? my father passed away last year from stage Four… He had a melanoma removed two years earlier, it came back got into spine and he passed away. it was terrible. He was adopted and knows not about his family history, so i want and got checked and found out i hve this. can someone tell me how REGULARLY I SHOULD HAVE CHECK UPS PLS? and WHAT i shoudl get done AT THESE CHECK UPS? l have only been back for check up once since it was removed from my back with a two cm margin, and all they did was look at my moles and say everything looks ok and do i want a mole map

                                    I AM going to get a mole map , are mole maps good?

                                     

                                    here is my diagnosis

                                    Skin Lesion right back, appearance consistent with early invasive malignant melanoma, arising from a dysplastic naevus, BRESLOW thickness zero point twenty five mm clark level II, no perineural or lymphovascular invasion. nearest superior resection margin to invasive component, 3 point six mm and to dysplastic nerves 1.1 mm, distance from tumour to deep margin 4.4 mm wider excision recommended.

                                     

                                    I had this removed.

                                     

                                    WHAT NEXT, can someone tell me what they think of this diagnosis. are things looking ok for me, or is this a NEVER ENDING THING, that you just have to keep checking your body forever and ever. to make sure you are not getting more.

                                     

                                    Sounds really depressing

                                    Thankyou. pls can someone tell me. thanks

                                    panda
                                    Participant

                                      Hi, i am Panda, the person who posted this original message. OK. i went to the doctors and got mydiagnosis again, and here it is can SOMEONE pls tell me if ths is not very good. So many people i am reading, once they have had a melonama cut out, keep going back for tests and getting checks for lumps, mole changes etc which is logical. but can someone tell me IS STAGE II very bad???? i really dont know…. Is it the one that is half way to STAGE FOUR? my father passed away last year from stage Four… He had a melanoma removed two years earlier, it came back got into spine and he passed away. it was terrible. He was adopted and knows not about his family history, so i want and got checked and found out i hve this. can someone tell me how REGULARLY I SHOULD HAVE CHECK UPS PLS? and WHAT i shoudl get done AT THESE CHECK UPS? l have only been back for check up once since it was removed from my back with a two cm margin, and all they did was look at my moles and say everything looks ok and do i want a mole map

                                      I AM going to get a mole map , are mole maps good?

                                       

                                      here is my diagnosis

                                      Skin Lesion right back, appearance consistent with early invasive malignant melanoma, arising from a dysplastic naevus, BRESLOW thickness zero point twenty five mm clark level II, no perineural or lymphovascular invasion. nearest superior resection margin to invasive component, 3 point six mm and to dysplastic nerves 1.1 mm, distance from tumour to deep margin 4.4 mm wider excision recommended.

                                       

                                      I had this removed.

                                       

                                      WHAT NEXT, can someone tell me what they think of this diagnosis. are things looking ok for me, or is this a NEVER ENDING THING, that you just have to keep checking your body forever and ever. to make sure you are not getting more.

                                       

                                      Sounds really depressing

                                      Thankyou. pls can someone tell me. thanks

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