{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:47:27Z","timestamp":1789847247916,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,10,10]],"date-time":"2016-10-10T00:00:00Z","timestamp":1476057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,1]]},"abstract":"\n Aims<\/jats:title>\n \n In 1970, Breslow described his eponymously named thickness measurement. No\u2010one has sought to enhance the Breslow thickness (\n BT<\/jats:styled-content>\n ). The aim of this study was to demonstrate a proof of concept that the density of melanoma cells at the position where the\n BT<\/jats:styled-content>\n is measured is a morphological prognostic biomarker, which we name the Breslow density (\n BD<\/jats:styled-content>\n ). The hypothesis was that the\n BD<\/jats:styled-content>\n has prognostic value for overall survival (\n OS<\/jats:styled-content>\n ) and is independent of the\n BT<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and results<\/jats:title>\n \n We analysed 100 cutaneous melanomas, and followed\n REMARK<\/jats:styled-content>\n guidelines. The\n BD<\/jats:styled-content>\n was the estimated percentage dermal area occupied by melanoma cells in a specified location. The\n BT<\/jats:styled-content>\n and\n BD<\/jats:styled-content>\n had a strong correlation (\n P<\/jats:italic>\n = 2.1 \u00d7 10\n \u221211<\/jats:sup>\n ) but, despite this, they were independent prognostic factors for\n OS<\/jats:styled-content>\n in Cox regression [\n BD<\/jats:styled-content>\n hazard ratio (\n HR<\/jats:styled-content>\n ) 1.03,\n P<\/jats:italic>\n = 0.001849; and\n BT HR<\/jats:styled-content>\n 1.09,\n P<\/jats:italic>\n = 0.000146]. This was corroborated by an independent effect on melanoma\u2010specific survival. We assessed whether the\n BT<\/jats:styled-content>\n and\n BD<\/jats:styled-content>\n could be combined into a Breslow score. A prognostic index based on Cox regression coefficients was used, and this showed a marginal improvement in predicted 5\u2010year survival as compared with the\n BT<\/jats:styled-content>\n alone (area under the curve of 94.8% versus 96.7%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n We show a proof of concept that the\n BD<\/jats:styled-content>\n represents a novel morphological prognostic biomarker that is independent of the\n BT<\/jats:styled-content>\n , and that there is potential to combine these into a Breslow score. Larger studies are needed to validate the\n BD<\/jats:styled-content>\n , but the simplicity of this biomarker makes it a strong candidate for translation to clinical practice.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/his.13060","type":"journal-article","created":{"date-parts":[[2016,8,9]],"date-time":"2016-08-09T04:38:51Z","timestamp":1470717531000},"page":"264-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Breslow density is a novel prognostic feature in cutaneous malignant melanoma"],"prefix":"10.1111","volume":"70","author":[{"given":"Hala","family":"Rashed","sequence":"first","affiliation":[{"name":"Department of Cellular Pathology University Hospitals of Leicester East Midlands Pathology Services (EMPATH) Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Flatman","sequence":"additional","affiliation":[{"name":"Department of Cancer Studies University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Bamford","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology University Hospitals of Leicester East Midlands Pathology Services (EMPATH) Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah W","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Cancer Studies University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Saldanha","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology University Hospitals of Leicester East Midlands Pathology Services (EMPATH) Leicester UK"},{"name":"Department of Cancer Studies University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197011000-00017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.4799"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960401)77:7<1303::AID-CNCR12>3.0.CO;2-5"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13171"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-62703-727-3_16"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2006.02.021"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-3086-3"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1979.tb03020.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197901)43:1<157::AID-CNCR2820430123>3.0.CO;2-S"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.2235"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12586"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198808000-00004"},{"key":"e_1_2_7_14_1","volume-title":"A language and environment for statistical computing","author":"R Core Team","year":"2013"},{"key":"e_1_2_7_15_1","unstructured":"TherneauT.A package for survival analysis in S. Version 2.38.2015;http:\/\/CRAN.R-project.org\/package=survival."},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.01.0454"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8635(18)30368-1"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199604000-00009"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356121"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhis.13060","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhis.13060","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.13060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T02:28:12Z","timestamp":1696300092000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.13060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,10]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1111\/his.13060"],"URL":"https:\/\/doi.org\/10.1111\/his.13060","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,10]]},"assertion":[{"value":"2016-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}