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August 1994, Vol 130, No. 8 >
Article | August 1994

Risk of Cutaneous Malignant Melanoma in Patients With 'Classic' Atypical-Mole Syndrome: Title and subTitle BreakA Case-Control Study

Ashfaq A. Marghoob, MD; Alfred W. Kopf, MD; Darrell S. Rigel, MD; Robert S. Bart, MD; Robert J. Friedman, MD; Sandhya Yadav, MD; Michelle Abadir, MD; Louis Sanfilippo; Mark K. Silverman, MD; Katrien A. Vossaert, MD
[+] Author Affiliations

From the Ronald O. Perelman Department of Dermatology, New York (NY) University School of Medicine; Oncology Section, Charles C. Harris Skin and Cancer Pavilion, New York (NY) University Medical Center, Melanoma Cooperative Group, New York University (Drs Kopf, Rigel, Bart, Friedman, Yadav, Abadir, Sanfilippo, Silverman, and Vossaert); and the Department of Dermatology, State University of New York at Stony Brook (Dr Marghoob).


Arch Dermatol. 1994;130(8):993-998. doi:10.1001/archderm.1994.01690080059007
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Background and Design:  There is an increased risk of developing cutaneous malignant melanomas (MMs) in patients with classic atypical-mole syndrome (AMS). This study compares the incidence of newly diagnosed MMs in patients with classic AMS (cases) with the incidence of newly diagnosed MMs developing in a population without classic AMS (control patients). The charts of 287 white patients with AMS and 831 white patients without AMS were reviewed for the occurrence of newly diagnosed invasive MMs during follow-up. Both cases and control patients were followed up regularly by total-body cutaneous examinations. The cumulative 10-year risk for developing newly diagnosed invasive MMs was calculated (life-table method) for each cohort.

Results:  Of the 287 AMS cases, 10 developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 10.7%. Of the 831 control patients, two developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 0.62%.

Conclusion:  Patients with classic AMS, regardless of the presence of a personal and/or family history of MM, are at significantly increased risk of developing invasive MMs compared with control patients.(Arch Dermatol. 1994;130:993-998)

REFERENCES

1 +
Friedman RJ, Rigel DS, Kopf AW, Harris MN, Baker D. Cancer of the Skin . Philadelphia, Pa: WB Saunders Co; 1991;.
2 +
Clark WH Jr, Reimer RR, Greene M, Ainsworth AM, Mastrangelo MJ.  Origin of familial malignant melanomas from heritable melanocytic lesions: the B-K mole syndrome . Arch Dermatol. 1978;;114:732-738.
3 +
Tiersten AD, Grin CM, Kopf AW, et al.  Prospective follow-up for malignant melanoma in patients with atypical-mole (dysplastic-nevus) syndrome . J Dermatol Surg Oncol. 1991;;17:44-48.
4 +
Rigel DS, Rivers JK, Kopf AW, et al.  Dysplastic nevi: markers for increased risk for melanoma . Cancer. 1989;;63:386-389.
5 +
Halpern AC, Guerry D IV, Elder DE, Trock B, Synnestvedt M.  A cohort study of melanoma in patients with dysplastic nevi . J Invest Dermatol. 1993;;100:346S-349S.
6 +
Schneider JS, Moore DH II, Sagebiel RW.  Risk factors for melanoma incidence in prospective follow-up: the importance of atypical (dysplastic) nevi . Arch Dermatol. 1994;;130:1002-1007.
7 +
McHenry PM, MacKie RM.  Prospective study of the value of surveillance in individuals thought to be at increased risk of developing melanoma . Br J Dermatol. 1993;;129:7-16.
8 +
Slade J, Salopek TG, Marghoob AM, Kopf AW, Rigel DS.  Risk of malignant melanoma in atypical-mole syndrome: NYU experience and literature review . Rec Res Cancer Res. In press.
9 +
Greene MH, Clark WH Jr, Tucker MA, Kraemer KH, Elder DE, Fraser MC.  High risk of malignant melanoma in melanoma-prone families with dysplastic nevi . Ann Intern Med. 1985;;102:458-465.
10 +
Kraemer KH, Greene MH, Tarone R, Elder DE, Clark WH Jr, Guerry D.  Dysplastic naevi and cutaneous melanoma risk . Lancet. 1983;;2:1076-1077.
11 +
Halpern AC, Guerry D, Elder DE, et al.  Dysplastic nevi as risk markers of spo- radic (nonfamilial) melanoma: a case-control study . Arch Dermatol. 1991;;127: 995-999.
12 +
Rivers JK, Kopf AW, Vinokur AF, et al.  Clinical characteristics of malignant melanomas developing in persons with dysplastic nevi . Cancer. 1990;;65:1232-1236.
13 +
Kraemer KH, Greene MH.  Dysplastic nevus syndrome, familial and sporadic precursors of cutaneous melanoma . Dermatol Clin. 1985;;3:225-237.
14 +
Kraemer KH, Tucker M, Tarone R, Elder DE, Clark WH Jr.  Risk of cutaneous melanoma in dysplastic nevus syndrome types A and B . N Engl J Med. 1986;; 2:1615-1616.
15 +
Elder DE, Goldman LI, Goldman SC, Greene MH, Clark WH Jr.  Dysplastic nevus syndrome: a phenotypic association of sporadic cutaneous melanoma . Cancer. 1980;;46:1787-1794.
16 +
Holly EA, Kelly JW, Shpall SN, Chiu SH.  Number of melanocytic nevi as a major risk factor for malignant melanoma . J Am Acad Dermatol. 1987;;17:459-468.
17 +
Greene MH, Clark WH Jr, Tucker MA, et al.  Acquired precursors of cutaneous malignant melanoma: the familial dysplastic nevus syndrome . N Engl J Med. 1985;;312:91-97.
18 +
Albert LS, Rhodes AR, Sober AJ.  Dysplastic melanocytic nevi and cutaneous melanoma: markers of increased melanoma risk for affected persons and blood relatives . J Am Acad Dermatol. 1990;;22:69-75.
19 +
Ries LAG, Hankey BF, Miller BA, Hartman AM, Edwards BK. Cancer Statistics Review 1973-1988 . Bethesda, Md: National Cancer Institute; 1991;. National Institutes of Health publication No. 91-2789.
20 +
Kopf AW, Friedman RJ, Rigel DS.  Atypical mole syndrome . J Am Acad Dermatol. 1990;;22:117-118.
21 +
McBride A, Rivers JK, Kopf AW, et al.  Clinical features of dysplastic nevi . Dermatol Clin. 1991;;9:717-722.
22 +
Slue W, Kopf AW, Rivers JK.  Total-body photographs of dysplastic nevi . Arch Dermatol. 1988;;124:1239-1243.
23 +
Rigel DS, Rivers JK, Friedman RJ, Kopf AW.  Risk gradient for malignant melanoma in individuals with dysplastic naevi . Lancet. 1988;;1:352-353.
24 +
Cutler SJ, Ederer F.  Maximum utilization of the life table method in analyzing survival . J Chronic Dis. 1958;;8:699-712.
25 +
Lee E. Statistical Methods for Survival Data Analysis . Belmont, Calif: Lifetime Learning Publications; 1980;.
26 +
Gehan E.  Estimating survival functions from the life-table . J Chronic Dis. 1969;; 21:629-644.
27 +
Lee E, Desu M.  A computer program for comparing k samples with right-censored data . Comput Methods Programs Biomed. 1972;;2:315-321.
28 +
SPSS-X User's Guide . 3rd ed. Chicago, III: SPSS Inc; 1988;.
29 +
Breslow A.  Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma . Ann Surg. 1970;;172:902-908.
30 +
Ackerman AB, Su WPD.  The histology of cutaneous malignant melanoma . In: Kopf AW, Bart RS, Rodriguez-Sains RS, et al, eds. Cutaneous Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1979;.
31 +
Kopf AW, Hellman LJ, Rogers GS, et al.  Familial malignant melanoma . JAMA. 1986;;256:1915-1919.
32 +
Friedman RJ, Heilman ER, Rigel DS, Kopf AW.  The dysplastic nevus, clinical and pathologic features . Dermatol Clin. 1985;;3:239-249.
33 +
Greene MH.  The dysplastic nevus syndrome: precursors of hereditary and non-familial cutaneous melanoma . Important Adv Oncol. 1986;;173-191.
34 +
Elder DE.  Dysplastic nevi: their significance and management . Dermatol Clin. 1988;;6:257-269.
35 +
Piepkorn M, Meyer LJ, Goldgar D, et al.  The dysplastic melanocytic nevus: a prevalent lesion that correlates poorly with clinical phenotype . J Am Acad Dermatol. 1989;;20:407-415.
36 +
Cooke KR, Spears GFS, Elder DE, Greene MH.  Dysplastic naevi in a population-based survey . Cancer. 1989;;63:1240-1244.
37 +
Kelly JW, Crutcher WA, Sagebiel RW.  Clinical diagnosis of dysplastic melanocytic nevi . J Am Acad Dermatol. 1986;;14:1044-1052.
38 +
Piepkorn M.  A hypothesis incorporating the histologic characteristics of dysplastic nevi into the normal biological development of melanocytic nevi . Arch Dermatol. 1990;;126:514-518.
39 +
Evans RD, Kopf AW, Lew RA, et al.  Risk factors for the development of malignant melanoma, I: review of case-control studies . J Dermatol Surg Oncol. 1988;;14:393-408.

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Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Friedman RJ, Rigel DS, Kopf AW, Harris MN, Baker D. Cancer of the Skin . Philadelphia, Pa: WB Saunders Co; 1991;.
2 +
Clark WH Jr, Reimer RR, Greene M, Ainsworth AM, Mastrangelo MJ.  Origin of familial malignant melanomas from heritable melanocytic lesions: the B-K mole syndrome . Arch Dermatol. 1978;;114:732-738.
3 +
Tiersten AD, Grin CM, Kopf AW, et al.  Prospective follow-up for malignant melanoma in patients with atypical-mole (dysplastic-nevus) syndrome . J Dermatol Surg Oncol. 1991;;17:44-48.
4 +
Rigel DS, Rivers JK, Kopf AW, et al.  Dysplastic nevi: markers for increased risk for melanoma . Cancer. 1989;;63:386-389.
5 +
Halpern AC, Guerry D IV, Elder DE, Trock B, Synnestvedt M.  A cohort study of melanoma in patients with dysplastic nevi . J Invest Dermatol. 1993;;100:346S-349S.
6 +
Schneider JS, Moore DH II, Sagebiel RW.  Risk factors for melanoma incidence in prospective follow-up: the importance of atypical (dysplastic) nevi . Arch Dermatol. 1994;;130:1002-1007.
7 +
McHenry PM, MacKie RM.  Prospective study of the value of surveillance in individuals thought to be at increased risk of developing melanoma . Br J Dermatol. 1993;;129:7-16.
8 +
Slade J, Salopek TG, Marghoob AM, Kopf AW, Rigel DS.  Risk of malignant melanoma in atypical-mole syndrome: NYU experience and literature review . Rec Res Cancer Res. In press.
9 +
Greene MH, Clark WH Jr, Tucker MA, Kraemer KH, Elder DE, Fraser MC.  High risk of malignant melanoma in melanoma-prone families with dysplastic nevi . Ann Intern Med. 1985;;102:458-465.
10 +
Kraemer KH, Greene MH, Tarone R, Elder DE, Clark WH Jr, Guerry D.  Dysplastic naevi and cutaneous melanoma risk . Lancet. 1983;;2:1076-1077.
11 +
Halpern AC, Guerry D, Elder DE, et al.  Dysplastic nevi as risk markers of spo- radic (nonfamilial) melanoma: a case-control study . Arch Dermatol. 1991;;127: 995-999.
12 +
Rivers JK, Kopf AW, Vinokur AF, et al.  Clinical characteristics of malignant melanomas developing in persons with dysplastic nevi . Cancer. 1990;;65:1232-1236.
13 +
Kraemer KH, Greene MH.  Dysplastic nevus syndrome, familial and sporadic precursors of cutaneous melanoma . Dermatol Clin. 1985;;3:225-237.
14 +
Kraemer KH, Tucker M, Tarone R, Elder DE, Clark WH Jr.  Risk of cutaneous melanoma in dysplastic nevus syndrome types A and B . N Engl J Med. 1986;; 2:1615-1616.
15 +
Elder DE, Goldman LI, Goldman SC, Greene MH, Clark WH Jr.  Dysplastic nevus syndrome: a phenotypic association of sporadic cutaneous melanoma . Cancer. 1980;;46:1787-1794.
16 +
Holly EA, Kelly JW, Shpall SN, Chiu SH.  Number of melanocytic nevi as a major risk factor for malignant melanoma . J Am Acad Dermatol. 1987;;17:459-468.
17 +
Greene MH, Clark WH Jr, Tucker MA, et al.  Acquired precursors of cutaneous malignant melanoma: the familial dysplastic nevus syndrome . N Engl J Med. 1985;;312:91-97.
18 +
Albert LS, Rhodes AR, Sober AJ.  Dysplastic melanocytic nevi and cutaneous melanoma: markers of increased melanoma risk for affected persons and blood relatives . J Am Acad Dermatol. 1990;;22:69-75.
19 +
Ries LAG, Hankey BF, Miller BA, Hartman AM, Edwards BK. Cancer Statistics Review 1973-1988 . Bethesda, Md: National Cancer Institute; 1991;. National Institutes of Health publication No. 91-2789.
20 +
Kopf AW, Friedman RJ, Rigel DS.  Atypical mole syndrome . J Am Acad Dermatol. 1990;;22:117-118.
21 +
McBride A, Rivers JK, Kopf AW, et al.  Clinical features of dysplastic nevi . Dermatol Clin. 1991;;9:717-722.
22 +
Slue W, Kopf AW, Rivers JK.  Total-body photographs of dysplastic nevi . Arch Dermatol. 1988;;124:1239-1243.
23 +
Rigel DS, Rivers JK, Friedman RJ, Kopf AW.  Risk gradient for malignant melanoma in individuals with dysplastic naevi . Lancet. 1988;;1:352-353.
24 +
Cutler SJ, Ederer F.  Maximum utilization of the life table method in analyzing survival . J Chronic Dis. 1958;;8:699-712.
25 +
Lee E. Statistical Methods for Survival Data Analysis . Belmont, Calif: Lifetime Learning Publications; 1980;.
26 +
Gehan E.  Estimating survival functions from the life-table . J Chronic Dis. 1969;; 21:629-644.
27 +
Lee E, Desu M.  A computer program for comparing k samples with right-censored data . Comput Methods Programs Biomed. 1972;;2:315-321.
28 +
SPSS-X User's Guide . 3rd ed. Chicago, III: SPSS Inc; 1988;.
29 +
Breslow A.  Thickness, cross-sectional areas and depth of invasion in the prognosis of cutaneous melanoma . Ann Surg. 1970;;172:902-908.
30 +
Ackerman AB, Su WPD.  The histology of cutaneous malignant melanoma . In: Kopf AW, Bart RS, Rodriguez-Sains RS, et al, eds. Cutaneous Malignant Melanoma . New York, NY: Masson Publishing USA Inc; 1979;.
31 +
Kopf AW, Hellman LJ, Rogers GS, et al.  Familial malignant melanoma . JAMA. 1986;;256:1915-1919.
32 +
Friedman RJ, Heilman ER, Rigel DS, Kopf AW.  The dysplastic nevus, clinical and pathologic features . Dermatol Clin. 1985;;3:239-249.
33 +
Greene MH.  The dysplastic nevus syndrome: precursors of hereditary and non-familial cutaneous melanoma . Important Adv Oncol. 1986;;173-191.
34 +
Elder DE.  Dysplastic nevi: their significance and management . Dermatol Clin. 1988;;6:257-269.
35 +
Piepkorn M, Meyer LJ, Goldgar D, et al.  The dysplastic melanocytic nevus: a prevalent lesion that correlates poorly with clinical phenotype . J Am Acad Dermatol. 1989;;20:407-415.
36 +
Cooke KR, Spears GFS, Elder DE, Greene MH.  Dysplastic naevi in a population-based survey . Cancer. 1989;;63:1240-1244.
37 +
Kelly JW, Crutcher WA, Sagebiel RW.  Clinical diagnosis of dysplastic melanocytic nevi . J Am Acad Dermatol. 1986;;14:1044-1052.
38 +
Piepkorn M.  A hypothesis incorporating the histologic characteristics of dysplastic nevi into the normal biological development of melanocytic nevi . Arch Dermatol. 1990;;126:514-518.
39 +
Evans RD, Kopf AW, Lew RA, et al.  Risk factors for the development of malignant melanoma, I: review of case-control studies . J Dermatol Surg Oncol. 1988;;14:393-408.

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