Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age

J Am Acad Dermatol. 2016 Apr;74(4):731-8. doi: 10.1016/j.jaad.2015.11.014. Epub 2016 Jan 20.

Abstract

Background: Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women.

Objective: This study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years.

Methods: All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded.

Results: A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger (P < .0008). Positive sentinel node status (P < .008), recurrence rates, metastatic disease (P < .001), and death rates (P < .008) were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence (P < .001), 7-fold increase in metastasis (P = .03) and 5-fold increase in mortality (P = .06).

Limitations: This was a retrospective study.

Conclusion: The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.

Keywords: melanoma; outcomes; pregnancy; pregnancy-associated melanoma; sentinel node; survival; young.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Biopsy, Needle
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / pathology*
  • Melanoma / epidemiology
  • Melanoma / pathology*
  • Melanoma / therapy
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Staging
  • Pregnancy
  • Pregnancy Complications, Neoplastic / epidemiology
  • Pregnancy Complications, Neoplastic / pathology*
  • Pregnancy Complications, Neoplastic / therapy
  • Retrospective Studies
  • Risk Assessment
  • Sentinel Lymph Node Biopsy / methods
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy
  • Survival Analysis
  • Treatment Outcome
  • United States / epidemiology
  • Young Adult