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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 31 octobre 2019
Doi : 10.1016/j.jaad.2019.07.037
accepted : 11 July 2019
Negative predictive value of biopsy margins of dysplastic nevi: A single-institution retrospective review

James Robert Duncan, MD , Joseph Chase Purnell, MD, Michael Slade Stratton, MD, Peter G. Pavlidakey, MD, Conway Huang, MD, Carlton Blake Phillips, MD
 Department of Dermatology, University of Alabama Birmingham, Birmingham, AL 

Correspondence to: James Robert Duncan, MD, University of Alabama Birmingham, Department of Dermatology, EFH 500, 1720 2nd Ave S, Birmingham, AL 35294.University of Alabama BirminghamDepartment of DermatologyEFH 5001720 2nd Ave SBirminghamAL35294

Biopsies of dysplastic nevi processed by bread-loafing allow for limited margin assessment; however, reported biopsy margins often influence management.


To evaluate the negative predictive value of biopsy margins of dysplastic nevi.


A retrospective search of a single academic institution's pathology database was conducted to identify all biopsy specimens of dysplastic nevi between January 1, 2015, and December 31, 2017. Biopsy specimen margin assessments were compared with excision pathology reports to calculate negative predictive value and to assess the frequency of residual nevus on excision after positive biopsy margins.


A total of 1245 dysplastic nevi from 934 patients were identified. Clear biopsy margins had a negative predictive value for the absence of residual nevus on excision of 87.3% for dysplastic nevi of moderate atypia or greater. Residual nevus was identified on excision in 29.41% of cases of dysplastic nevi of moderate atypia or greater when initial biopsy margins were positive.


This was a retrospective, single-institution study. The calculations likely overestimate the true negative predictive value of biopsy margins because of processing of excision specimens by bread-loafing.


This study provides additional evidence that reported biopsy margins are not representative of true margin status.

The full text of this article is available in PDF format.

Key words : biopsy, bread-loafing, dysplastic, margins, negative predictive value, nevi, nevus

Abbreviations used : FN, FP, TN, TP

 Funding sources: None.
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.

© 2019  American Academy of Dermatology, Inc.@@#104156@@
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