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Patients With Fewer Than 50 Moles May Be at Risk for More Aggressive Melanoma

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Key Points

  • Patients with fewer moles had thicker, more aggressive melanoma than those with many moles.
  • The tendency toward thinner, less aggressive melanoma was observed in patients with both a high number of moles and atypical moles.
  • Those with more than 50 moles were more likely to be diagnosed with melanoma at a younger age than those with fewer moles.

People with more than 50 moles have an increased risk of developing melanoma, but those with fewer than 50 moles should still be alert for this disease. In fact, according to new research presented at the American Academy of Dermatology’s 2015 Summer Academy Meeting in New York, those with fewer moles may be diagnosed with more aggressive melanoma than those with many moles.

These findings were presented by Caroline C. Kim, MD, FAAD, Director of the Pigmented Lesion Clinic and Associate Director of the Cutaneous Oncology Program in the Beth Israel Deaconess Medical Center Department of Dermatology.

People with more than 50 moles may be more aware of their skin cancer risk and more likely to visit the dermatologist for screenings, Dr. Kim said. In treating advanced-stage melanoma cases, however, she observed that patients with fewer moles tended to have more aggressive melanoma than those with many moles.

Study Details

To investigate the differences in melanoma between these two groups, Dr. Kim and her colleagues reviewed the charts of 281 patients with melanoma who visited Beth Israel Deaconess Medical Center in 2013 and 2014. Of these patients, 89 had more than 50 moles, and the remaining 192 had fewer than 50 moles.

As Dr. Kim suspected, patients with fewer moles had thicker, more aggressive melanoma than those with many moles. The tendency toward thinner, less aggressive melanoma was observed in patients with both a high number of moles and atypical moles, another melanoma risk factor. Additionally, those with more than 50 moles were more likely to be diagnosed with melanoma at a younger age than those with fewer moles.

Reasons for Discrepancy

Dr. Kim said the results of the research could be attributable to several factors. Health-care providers may readily identify patients with more than 50 moles as being at risk for melanoma and educate those patients regarding that risk. As a result, patients with many moles may be more likely to visit a dermatologist for regular skin exams, allowing for their melanoma to be detected at an earlier stage, when it is thinner and less aggressive.

Additionally, there are biologic differences between patients with many moles and those with few moles, Dr. Kim said, and these differences may be responsible for the variations in melanoma between the two groups.

“We already know that melanomas are not all the same genetically,” she explained. “It’s possible that there are different pathways that drive melanoma in these two patient groups, resulting in different degrees of aggressiveness. If patients with fewer moles are more prone to aggressive melanoma, then we need to make sure that they are also being educated and screened, in addition to patients with many moles.”

Dr. Kim says additional large-scale studies will be necessary to confirm the results of her research. Further investigation into the biology of melanoma in these two patient groups will be important, she said, and research on the benefits of population-wide skin cancer screenings may indicate a need for expanded skin cancer detection efforts.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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