Normal Tx advised for melanoma in pregnancy. (Prompt Biopsy is Key).

LA JOLLA, CALIF. -- Pregnant women with stage I and II melanoma should be treated exactly the same as nonpregnant patients who present with changing nevi, Dr. Craig Naugle said at a melanoma update sponsored by the Scripps Clinic.

"The same standard of care should be applied to pregnant and nonpregnant patients," said Dr. Naugle, a Mohs fellow in the division of dermatology and cutaneous surgery at the clinic. "The key here is to avoid a delay in diagnosis. Women who present with changing nevi in pregnancy should be biopsied promptly and should not wait until they deliver.

Studies consistently show an increased median thickness in pregnant patients with melanoma vs. nonpregnant, age-matched controls. In Dr. Naugle's opinion, this happens because some physicians hesitate to biopsy pregnant patients, despite the lack of evidence that pregnancy during or after melanoma diagnosis adversely affects the patient's outcome, compared with nonpregnant patients.

Another reason for a delayed diagnosis stems from the common belief that growth factors during pregnancy induce thicker and more rapidly growing melanomas. No studies prove that notion, either.

Transplacental metastases only occur in patients with hematogenous dissemination of melanoma. The ...