The level of a melanoma is determined at the time of surgical excision. Melanoma can spread through the bloodstream to the lungs, liver or bone. Melanoma can also spread through the lymphatic system to the lymph nodes. If either of these events have occurred, the prognosis is poor. All melanomas must be surgically removed.
Additional treatments depend on the stage of the melanoma.
Although Clark level and Breslow thickness are determined to help predict prognosis, treatment is based on the clinical stage of the melanoma. The tumor is 1.5mm to 4mm thick and involves the lower portion of the dermis but not tissues deep to the skin or surrounding lymph nodes. The tumor has spread to distant areas of the body such as brain or lung. Treatment Surgical removal is the primary treatment for all stages of melanoma. Typically, 1-2 cm margins around the tumor are taken at the time of surgery.