Stages of Melanoma

The diagnosis of melanoma involves three phases:

The suspicious lesion is biopsied and tested for cancerous cells.
If melanoma is diagnosed, the next step is to identify the type of melanoma that is present.
Once the type of melanoma is identified, the stage of cancer must be determined.

When doctors talk about the “stage of melanoma,” they are referring to the degree of severity of the melanoma, which is based on the tumor’s physical characteristics and if/where the melanoma has spread. Once the stage has been determined, our doctors can create the most effective plan for treating the melanoma.

Melanoma Staging System

The staging system that is currently used was established through a joint effort of cancer centers around the world. The system is constantly updated to include new findings about melanoma so that doctors can provide an accurate diagnosis and predict how the disease will likely progress, which allows them to create an effective treatment plan. Below we have a provided a summary of the basic characteristics of each stage.

In order to understand how melanoma is classified, it’s helpful to know the meaning of these terms:

Ulcerated – when the skin over the tumor has broken, it is described as ulcerated.
Mitotic rate – the rate at which the cells in the cancerous area are dividing. In general, higher mitotic rates are associated with a lower chance of survival.

Stage 0

In this stage of melanoma, the tumor is non-invasive.
Melanoma cells are only found in the epidermis, the top layer of the skin
Melanoma has not yet begun to spread to other parts of the skin or body

Stage 1

In Stage 1, the cancer has spread deeper into the skin, but has not spread to other parts of the body. This stage is broken into two sub-classifications, as follows:

Stage 1A

Melanoma is less than 1mm thick
The skin covering the tumor is not ulcerated
Mitotic rate is less than 1/mm2
There are no signs that the cancer has spread to the lymph nodes or other areas of the body

Stage 1B

Less than 1mm thick and skin is ulcerated OR 1 – 2mm thick and has not ulcerated
Has a mitotic rate greater than 1/mm2
Cancerous cells have not spread to lymph nodes or other parts of the body

Stage 2

Stage 2 melanomas are more advanced than stage 1 melanomas, but have not spread to the lymph nodes or other parts of the body. There are three sub-classifications in stage 2.

Stage 2A

The melanoma is 1 – 2 mm thick and ulcerated OR 2 – 4 mm thick and not ulcerated
Melanoma has not spread to other parts of the body

Stage 2B

The tumor is 2 – 4 mm thick and ulcerated OR thicker than 4mm and not ulcerated
No sign that the melanoma has spread into the body

Stage 3

Stage 3 is diagnosed when the melanoma has spread to lymph nodes that are close to the tumor. There are three sub-classifications.

Stage 3A

Melanoma has spread to no more than 3 lymph nodes near the tumor, but the nodes are not enlarged
Melanoma is not ulcerated and has not spread to other parts of the body

Stage 3B

The Melanoma is ulcerated and has spread to 1 – 3 lymph nodes, which are not enlarged OR
The melanoma is not ulcerated and has spread to 1 – 3 nearby lymph nodes, which are enlarged OR
The melanoma is not ulcerated and has spread to small areas of skin or lymphatic channels, but lymph nodes close to the tumor don’t contain cancerous cells

Stage 3C

Melanoma cells are found in the lymph nodes and small areas of the skin or lymph channels near to the primary tumor OR
The tumor is ulcerated and has spread to 1 – 3 nearby lymph nodes that are enlarged OR
The melanoma has spread to 4 or more nearby lymph modes OR
The melanoma has spread to lymph nodes that have joined together

Stage 4

Stage 4 is the most serious stage of melanoma. In this stage, the melanoma has spread to other parts of the body and is no longer isolated to the skin and lymph nodes near the primary tumor. Melanoma most commonly spreads to the lung, brain, liver, or skin and lymph nodes far from the original tumor.

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