The short answer
Two facts on your pathology report drive melanoma follow-up: the Breslow thickness in millimeters, and whether the melanoma was ulcerated. Node surgery is a separate question, and because a personal history of melanoma is itself a risk factor, skin surveillance never stops.
Breslow thickness is the vertical depth of the melanoma in millimeters, and NCI says it is more reproducible than the older Clark level and should always be reported.
NCI says sentinel node biopsy should be considered when the primary melanoma is at least 0.8 mm thick and the nodes feel normal.
Removing all the nodes after a positive sentinel node is no longer automatic: in the trial NCI cites, lymphedema affected 24.1% after full dissection against 6.3% with observation, and no subgroup clearly benefited from the bigger operation.
A personal history of melanoma sits on NCI's own list of risk factors, which is why lifelong skin checks, including scalp, feet and nails, are part of follow-up.
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The full explanation.
The number on your pathology report
Melanoma follow-up is built on thickness. NCI describes the Breslow measurement, the vertical depth of the melanoma in millimeters.
NCI says Breslow thickness is more reproducible than the older Clark level, and predicts behavior better in lesions thicker than 1.5 mm. It should always be reported.
Find that number on your report. Find whether the word ulcerated appears. Those two facts drive most of what follows.
Whether your nodes were sampled, and what happened next
NCI says sentinel node biopsy should be considered when the primary melanoma is at least 0.8 mm thick and the nodes feel normal.
If a sentinel node was positive, ask what was done next. Removing all the nodes is no longer automatic.
In the trial NCI cites, lymphedema affected 24.1% of people who had the full dissection, compared with 6.3% of those observed. No subgroup was found that clearly benefited from the bigger operation.
Living with the arm or leg afterward
If you had a node dissection, swelling is the effect to watch. Ask for a referral to a lymphedema therapist early, rather than after the swelling settles in.
Numbness or tightness around the scar is common. Ask what is expected and what is not.
Skin checks for the rest of your life
NCI lists the risk factors for melanoma: sun exposure, pigmentary features, multiple moles, family and personal history of melanoma, immune suppression, and environmental exposures.
Read that list again. A personal history of melanoma is on it. That is why skin surveillance does not stop.
Ask to be taught a proper monthly self-check, including scalp, feet and under the nails.
Questions for the dermatology and melanoma clinic
- What was my Breslow thickness, and was my melanoma ulcerated?
- Was a sentinel node biopsy done, and what did it show?
- If a node was positive, why was dissection or observation chosen for me?
- How often should I have a full skin exam, and who does it?
- Should my close relatives have skin checks, given my history?
- I had adjuvant immunotherapy. Could a thyroid or adrenal problem still appear now?
- What counts as an urgent new skin change, and how do I get seen quickly?
When to bring in a second melanoma opinion
Consider it if your pathology report is ambiguous, if adjuvant treatment was offered without a clear reason, or if nobody has explained your recurrence risk in numbers you can use.
Related pages
Keep reading: Watching for Cancer Recurrence, Fear of Recurrence, Cancer Staging, and Questions to Ask Your Doctor.
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Words to know
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Common questions
What are the two numbers I should find on my pathology report?
The Breslow thickness in millimeters, and whether the word ulcerated appears. NCI says Breslow predicts behavior better than the older Clark level in lesions thicker than 1.5 mm. Those two facts shape most of your follow-up plan.
My sentinel node was positive. Why was I not offered a full node dissection?
Because the bigger operation has not been shown to help a defined group. In the trial NCI cites, lymphedema affected 24.1% of people who had the full dissection against 6.3% of those observed, and no subgroup was found that clearly benefited.
Why do I still need skin checks now that my melanoma is treated?
A personal history of melanoma is on NCI's list of melanoma risk factors, alongside sun exposure, many moles, family history and immune suppression. Ask to be taught a proper monthly self-check that includes your scalp, feet and under the nails.
Questions to ask your doctor
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Sources last checked: 2026-07-30 what this meansLast updated: 2026-08-16Next planned review: 2028-07-30
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How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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