Jim Muir, Gabriela Gonzalez Matheus, Daniel Lindsay, Isabel Gonzalez Matheus
Clinicians reported shave excision as faster and less resource-intensive than elliptical excision, with higher rates of same-day procedures and reduced follow-up. Median estimated total cost per procedure was $753 for shave excision versus $1473- $1504 for elliptical excision. Users reported favourable cosmetic outcomes and low incidence of deep margin involvement when performed appropriately.
BACKGROUND AND OBJECTIVES: Shave excisions are increasingly used in Australian clinical practice for melanoma diagnosis, yet concerns persist regarding margin involvement, diagnostic accuracy and cosmetic outcomes. This study assessed clinician perspectives on the estimated costs, logistics and outcomes of shave versus elliptical excision for melanoma diagnosis.
METHOD: An anonymous online survey was distributed to 229 Australian general practitioners and dermatologists involved in skin cancer management. Data on procedure setting, equipment, follow-up, costs and clinical perceptions were analysed.
RESULTS: Clinicians reported shave excision as faster and less resource-intensive than elliptical excision, with higher rates of same-day procedures and reduced follow-up. Median estimated total cost per procedure was $753 for shave excision versus $1473- $1504 for elliptical excision. Users reported favourable cosmetic outcomes and low incidence of deep margin involvement when performed appropriately.
DISCUSSION: Shave excision is likely a cost-saving, diagnostically reliable method for selected lesions. Further prospective research and guideline updates are warranted.