Just Diagnosed – Many Questiions

Your derm can say this because nothing really matters at this point.  Why worry now?  You need to have the additional surgeries and those results for staging.  You're kind of in the middle of the mix.  Certainly many people with lesions your size don't have spread but there are others with your depth and deeper that do.  There is really no way to speculate or make judgements at this time.

Your path report is pretty standard.  The only good/bad feature is regression.  Regression is good and bad.  It means the lesion was once bigger but the body recognized it and started attacking it.  The bad part is you can't always tell how big the lesion was before the body attacked it.

The WLE and SNB are the next steps and after you get those results, you'll know what the next step should be.  Considering anything before that is total speculation.  You'll have time when you know the results to figure out the next step – if any!

Sorry you had to join us here.

Your derm can say this because nothing really matters at this point.  Why worry now?  You need to have the additional surgeries and those results for staging.  You're kind of in the middle of the mix.  Certainly many people with lesions your size don't have spread but there are others with your depth and deeper that do.  There is really no way to speculate or make judgements at this time.

Your path report is pretty standard.  The only good/bad feature is regression.  Regression is good and bad.  It means the lesion was once bigger but the body recognized it and started attacking it.  The bad part is you can't always tell how big the lesion was before the body attacked it.

The WLE and SNB are the next steps and after you get those results, you'll know what the next step should be.  Considering anything before that is total speculation.  You'll have time when you know the results to figure out the next step – if any!

Sorry you had to join us here.

Your derm can say this because nothing really matters at this point.  Why worry now?  You need to have the additional surgeries and those results for staging.  You're kind of in the middle of the mix.  Certainly many people with lesions your size don't have spread but there are others with your depth and deeper that do.  There is really no way to speculate or make judgements at this time.

Your path report is pretty standard.  The only good/bad feature is regression.  Regression is good and bad.  It means the lesion was once bigger but the body recognized it and started attacking it.  The bad part is you can't always tell how big the lesion was before the body attacked it.

The WLE and SNB are the next steps and after you get those results, you'll know what the next step should be.  Considering anything before that is total speculation.  You'll have time when you know the results to figure out the next step – if any!

Sorry you had to join us here.

I'll have a go.Firstly, sorry you are going through this – it's physically tough but moreso it's mentally very tough as melanoma is such a slippery beast.

This page might help

https://www.oncolink.org/cancers/skin/melanoma/treatments/understanding-your-pathology-report-melanoma

Breslow 1.7mm – unfortunately over the magic 1mm mark where a SLNB is required – you are doing the right thing getting a WLE (probably a 1cm margin of skin cut from all around the site) and a SLNB because there is a small chance some melanoma cells have migrated to the sentinal lymph node. It's by no means a thick melanoma, but a little too deep to be thin. Let's call it intermediate.

Clark IV – Clark is an older measurement only really used for thinner melanomas – it measures invasion of the melanoma in the skin – yours has reached 4 out of possible 5 (invasion to the reticular dermis) – basically the deeper the melanoma invades, the more chance it has of contacting blood or lymph that might take it to other sites/lymph nodes. So IV is not great, either.Might be to do with the anatomical site eg thinner skin on scalp.

Microsatellosis – no – this is a good thing, microsatellites are a high-risk indicator for spread to lymph nodes so 'no' is a good thing

Regression – partial – good because it shows an immune response, bad because it's hard to say how deep the melanoma was before it regressed

Mitotic rate – not good, more than 1 is considered to show a more aggressive melanoma with cells that are rapidly dividing – it's usually only useful for very thin melanomas though (less than 1mm)

No melanoma on margins – good, that means it is gone with first excision, WLE is a precaution that will hopefully only show healthy skin being removed (WLE is also tested but if your excision has clean margins, there's a good chane the WLE will be clean too)

There's not much you can do except for go on ahead with the WLE and SLNB and hope for the best. You'll need to be vigilant because head/neck melanomas are a little more likely to spread – vigilant but not paranoid as the odds are certainly in your favour.

I'm sorry you had to get this kind of news just before Christmas, but good that you have the thing gone, totally excised and hopefully you won't ever encounter it again.

I'll have a go.Firstly, sorry you are going through this – it's physically tough but moreso it's mentally very tough as melanoma is such a slippery beast.

This page might help

https://www.oncolink.org/cancers/skin/melanoma/treatments/understanding-your-pathology-report-melanoma

Breslow 1.7mm – unfortunately over the magic 1mm mark where a SLNB is required – you are doing the right thing getting a WLE (probably a 1cm margin of skin cut from all around the site) and a SLNB because there is a small chance some melanoma cells have migrated to the sentinal lymph node. It's by no means a thick melanoma, but a little too deep to be thin. Let's call it intermediate.

Clark IV – Clark is an older measurement only really used for thinner melanomas – it measures invasion of the melanoma in the skin – yours has reached 4 out of possible 5 (invasion to the reticular dermis) – basically the deeper the melanoma invades, the more chance it has of contacting blood or lymph that might take it to other sites/lymph nodes. So IV is not great, either.Might be to do with the anatomical site eg thinner skin on scalp.

Microsatellosis – no – this is a good thing, microsatellites are a high-risk indicator for spread to lymph nodes so 'no' is a good thing

Regression – partial – good because it shows an immune response, bad because it's hard to say how deep the melanoma was before it regressed

Mitotic rate – not good, more than 1 is considered to show a more aggressive melanoma with cells that are rapidly dividing – it's usually only useful for very thin melanomas though (less than 1mm)

No melanoma on margins – good, that means it is gone with first excision, WLE is a precaution that will hopefully only show healthy skin being removed (WLE is also tested but if your excision has clean margins, there's a good chane the WLE will be clean too)

There's not much you can do except for go on ahead with the WLE and SLNB and hope for the best. You'll need to be vigilant because head/neck melanomas are a little more likely to spread – vigilant but not paranoid as the odds are certainly in your favour.

I'm sorry you had to get this kind of news just before Christmas, but good that you have the thing gone, totally excised and hopefully you won't ever encounter it again.

I'll have a go.Firstly, sorry you are going through this – it's physically tough but moreso it's mentally very tough as melanoma is such a slippery beast.

This page might help

https://www.oncolink.org/cancers/skin/melanoma/treatments/understanding-your-pathology-report-melanoma

Breslow 1.7mm – unfortunately over the magic 1mm mark where a SLNB is required – you are doing the right thing getting a WLE (probably a 1cm margin of skin cut from all around the site) and a SLNB because there is a small chance some melanoma cells have migrated to the sentinal lymph node. It's by no means a thick melanoma, but a little too deep to be thin. Let's call it intermediate.

Clark IV – Clark is an older measurement only really used for thinner melanomas – it measures invasion of the melanoma in the skin – yours has reached 4 out of possible 5 (invasion to the reticular dermis) – basically the deeper the melanoma invades, the more chance it has of contacting blood or lymph that might take it to other sites/lymph nodes. So IV is not great, either.Might be to do with the anatomical site eg thinner skin on scalp.

Microsatellosis – no – this is a good thing, microsatellites are a high-risk indicator for spread to lymph nodes so 'no' is a good thing

Regression – partial – good because it shows an immune response, bad because it's hard to say how deep the melanoma was before it regressed

Mitotic rate – not good, more than 1 is considered to show a more aggressive melanoma with cells that are rapidly dividing – it's usually only useful for very thin melanomas though (less than 1mm)

No melanoma on margins – good, that means it is gone with first excision, WLE is a precaution that will hopefully only show healthy skin being removed (WLE is also tested but if your excision has clean margins, there's a good chane the WLE will be clean too)

There's not much you can do except for go on ahead with the WLE and SLNB and hope for the best. You'll need to be vigilant because head/neck melanomas are a little more likely to spread – vigilant but not paranoid as the odds are certainly in your favour.

I'm sorry you had to get this kind of news just before Christmas, but good that you have the thing gone, totally excised and hopefully you won't ever encounter it again.

Not trying to be negative but in May of 2015 I had a stage 2B on the back of my head lower left part of my crown. After 5 surguries I had cleared margins but no lymp noid biopsy. At that time all the research I found on stage 2B melanoma on the scalp told me that 95% of the time it shows up somewhere else later. June of 2016 I was drying off after a shower and felt a lump in my lower neck upper shoulder area and immediately knew what It was. That was on a Friday. On Monday I was at my surgeon's office and he said we need to get it out asap and schedule PET scan for entire body. I had the scan 2 days later and the surgury was scheduled the next Monday (amazing speed of events considering this was the VA). the scan results were back on Friday. They were not sure on the spot in my neck but were positive for the 7 mets in my lungs as they were not there on the previous scan from a year earlier. The spot in my neck also came back positive. I started the ipi/nivo combo 3 weeks later and so far my treatment has gone very well with very positive results. Since it is on your scalp I would be extremely vigilant in looking for any signs of it spreading anywhere.

Not trying to be negative but in May of 2015 I had a stage 2B on the back of my head lower left part of my crown. After 5 surguries I had cleared margins but no lymp noid biopsy. At that time all the research I found on stage 2B melanoma on the scalp told me that 95% of the time it shows up somewhere else later. June of 2016 I was drying off after a shower and felt a lump in my lower neck upper shoulder area and immediately knew what It was. That was on a Friday. On Monday I was at my surgeon's office and he said we need to get it out asap and schedule PET scan for entire body. I had the scan 2 days later and the surgury was scheduled the next Monday (amazing speed of events considering this was the VA). the scan results were back on Friday. They were not sure on the spot in my neck but were positive for the 7 mets in my lungs as they were not there on the previous scan from a year earlier. The spot in my neck also came back positive. I started the ipi/nivo combo 3 weeks later and so far my treatment has gone very well with very positive results. Since it is on your scalp I would be extremely vigilant in looking for any signs of it spreading anywhere.

Not trying to be negative but in May of 2015 I had a stage 2B on the back of my head lower left part of my crown. After 5 surguries I had cleared margins but no lymp noid biopsy. At that time all the research I found on stage 2B melanoma on the scalp told me that 95% of the time it shows up somewhere else later. June of 2016 I was drying off after a shower and felt a lump in my lower neck upper shoulder area and immediately knew what It was. That was on a Friday. On Monday I was at my surgeon's office and he said we need to get it out asap and schedule PET scan for entire body. I had the scan 2 days later and the surgury was scheduled the next Monday (amazing speed of events considering this was the VA). the scan results were back on Friday. They were not sure on the spot in my neck but were positive for the 7 mets in my lungs as they were not there on the previous scan from a year earlier. The spot in my neck also came back positive. I started the ipi/nivo combo 3 weeks later and so far my treatment has gone very well with very positive results. Since it is on your scalp I would be extremely vigilant in looking for any signs of it spreading anywhere.