In a new Clinical Decisions article, Ms. Evans, 52-year-old woman, awaits an assessment of her recent diagnosis of melanoma. She had initially presented to her primary care physician 6 weeks earlier with an irregular lesion on her right arm. After a punch biopsy, a superficial spreading melanoma was diagnosed. She was referred to a surgical oncologist for consultation and subsequently underwent wide local excision of the primary lesion and an axillary sentinel lymph-node biopsy.
Ms. Evans is visiting your clinic today to review the pathological findings and to determine the next steps in care. As the next step, would you recommend a completion lymph-node dissection, or an observation of the nodes using ultrasonography? Read more about this case, form your opinion as to which option will be more effective, and take a quick poll on which option you would choose.
Clinical Decisions are a great way to help you evaluate treatment options and gain insight from colleagues. The articles include a case vignette, plus clinically acceptable management options, each supported in a short commentary by a respected clinician. You are invited to vote for, and comment on, the options at NEJM.org, where a diverse range of thinking is presented. Browse previous Clinical Decisions articles here!
Read more at the New England Journal of Medicine