Internal Medicine

0521779407-14 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:16

Melanoma Menopause 967

➣Reticular dermis (Level IV)

➣Enters fat (Level V)

■Regression

■Ulceration

■Mitotic rate

■Microscopic satellitosis

■Vascular invasion

■Sentinel lymph node status

Stage II Melanoma

■Presence of vertical growth phase – radial > vertical

■Mitotic rate – lower > higher

■Tumor-infiltrating lymphocytes – absence > presence

■Tumor thickness

■Anatomic site

■Sex

■Regression – presence > absence

■Sentinel lymph node status

Stage III Melanoma

■Number of positive nodes – lower > higher

■Anatomic location

■Age

Stage IV Melanoma

■Number of metastatic sites – lower number > higher number

■Surgical respectability

■Duration of remission – longer > shorter

■Location of metastases

MENOPAUSE

MAXINE H. DORIN, MD

REVISED BY ANDREW R. HOFFMAN, MD; FREDRIC B. KRAEMER, MD; and

THOMAS F. McELRATH, MD, PhD

history & physical

History of Menstrual Pattern

■Menopause: no spontaneous menses for 1 full year

■Perimenopause: transitional years plus 1 y

■Average age of menopause: 51.2 y (>90% by age 55 y)

■Most begin perimenopause about age 47 y