
BWH Tumor Staging System
T1 (0 factors)
T2a (1 factor)
T2b (2-3 factors)
T3 (≥4 factors or bone invasion)
Factors include:
- Tumor diameter ≥2 cm
- Poorly differentiated tumor histology
- Perineural invasion ≥0.1 mm
- Tumor invasion beyond fat
Presence of Specific Risk Factors
Factors include:
- Tumor diameter ≥2 cm
- Specific tumor locations (for example, ear, lip, cheek, or temple)
- Immunosuppression
- Tumor invasion beyond fat
- Poorly differentiated histology
- Perineural invasion ≥0.1 mm

NCCN High-Risk
One or more of a large number of possible factors (broadest high-risk characterization)
Similar to Mohs Appropriate Use Criteria
Annual patient deaths from
Melanoma
Annual patient deaths from
SCC
Established management approaches (for primary treatment and follow up/surveillance) provide potential for reduced or earlier detection of metastasis as well as improved survival.