The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Concerned over incomplete biopsy

Forums Cutaneous Melanoma Community Concerned over incomplete biopsy

  • Post
    Flash1963
    Participant

      Hi, 
      I am sorry if this is not the proper place to post this.  But I am really concerned.  I have a family history on my mothers side of Melanoma.  I also have genetic markers for Melanoma.  I do not have a diagnosis for Melanoma.  But… 

      I had/have several areas that have changed and or are itching.  So I went to a Dermatologist.  He was very concerned over 4 of them but decided to biopsy 2 of them and wait for those results.  No problem.  

      He performed 2 shave biopsies.  One on my back that was the most concerning to him and one on my leg.  I waited the 24 hours to remove the bandages and noticed a very dark center of remaining pigment in the one on my back.  I researched the internet as the office was closed for the weekend at the time.  Of course your mind takes you where you do not want to go.  I found myself on this site reading many stories and hoping I would have a non-melanoma story to tell.

      The biopsy came back non cancer on both.  The leg one is classic benign mole. But the one on my back is a little different.  Don't get me wrong,  I am relieved but not unconcerned because in my mind, there is a portion that was not removed.  

      Compound Melanocytic Nevus
      Shave biopsy of skin showing an undulating epidermis. Occasional nests of melanocytes are noted along the dermal/epidermal junction absent of atypia. Nests of interstitial nevomelanocytes are noted in the underlying dermis, absent of cytologic and nuclear atypia.  

      So, I went for a follow up with my dr. today.  I showed him all my pictures.  He claims he always gets all of it and that he would never leave any portion of it behind so it is impossible that this is pigment.  I asked him detailed questions.  He did get a little defensive and his response was that it was a little scab or blood.  It is absolutely not. I confirmed that he did not use silver nitrate. He said that he reviewed the slides and that they were perfect as a normal mole.  He said that there was nothing anywhere but where the lesion was located which matches  the pathology report on my leg.   (He also now says the other 2 are fine. He was worried about all 4 last time.)

      This is where I lost all faith and confidence in what he said.  I believe he was referring to the leg slides if he even looked at any.  Nice enough guy, don't get me wrong.

      My most important questions were;  
      If this pigment remains, can it become a melanoma?  
      If it becomes melanoma, how will I know?
      If you didn't remove all of it, how do we know that it is normal throughout?

      I do not want cancer.  But I do not want to be one that comes back a year from now and they say, oops, either. I don't want to have something left behind that could become melanoma either.  I have a family history of melanoma and I have genetic markers for increased risks as well. So this is in the back of my mind.  I have found that Dr.'s who claim they "Never" or "Always" do something are frequently wrong and unable to admit it.

      So, what do I do?  
      Do I accept that this is not a concern and let it go until I have reason to believe otherwise?  
      Or do I seek another opinion?  
      Do I push for further biopsy of the remaining pigment from another dr?

      Pre biopsy
      http://i32.photobucket.com/albums/d13/kjmcooper1/prebiopsy_zps7xutkhp7.jpg

      24hrs
      http://i32.photobucket.com/albums/d13/kjmcooper1/biopsy1_zpsuxjmg2hb.jpg

      72 hrs
      http://i32.photobucket.com/albums/d13/kjmcooper1/biopsy2_zpsbaoukfpy.jpg

      1 week
      http://i32.photobucket.com/albums/d13/kjmcooper1/biopsy10days_zps9p9js1bt.jpg

      today
      http://i32.photobucket.com/albums/d13/kjmcooper1/6002a0b3-97e9-4be5-95ec-3740933058f5_zps6ifxs5y7.jpg

      For Reference the was my leg biopsy site. So I know the difference between blood/clot and pigment. 
      http://i32.photobucket.com/albums/d13/kjmcooper1/biopsy%20leg_zps1aypsiay.jpg

      Any advice would be greatly appreciated. 

       

    Viewing 0 reply threads
    • Replies
        UBContributor
        Participant

          unless your Dr is an oncologist experienced in MM, don't believe in nice guys…seek a second opinion, change dr, have it removed for god's sake, etc. 

            Flash1963
            Participant

              Thank you.  How do I know if its a good dermatologist or one that just wants to sell me botox?  Is there a way to finding someone?  Can you even go to an oncologist for a 2nd opinion without having cancer?  

               

              jennunicorn
              Participant

                I think what the other poster meant to say was you may want to see a dermatologist that specializes in skin cancers and not one that is mostly focused on other things, given your family history and just the fact that this derm isn't up to your satisfaction, and that's ok. Sometimes we have to doctor shop before we land on one we're comfortable with and we're confident they have our best interest in mind, not theirs. You can do a search in your area online, most university hospitals will have good dermatologists that know a good amount about melanoma and other skin cancers. You cannot see an oncologist without cancer diagnosis, and they are not ones who deal with skin biopsies anyway, the dermatologist does that. I'll be seeing my derm, who is a melanoma specialist derm and professor at a university, today for a skin check. And I'll see my oncologist, a melanoma specialist as well, on thursday for other things.

                Flash1963
                Participant

                  Thank you for clarifying all that.  Both of my grandparents have passed and my mother and I are estranged.  So this is all new to me.  I really appreciate it.  I live in a smaller area now, but I am not beyond driving to a bigger city to get a 2nd opinion or for someone more knowledgeable.  When you lose confidence in what they are telling you, it is hard to remain a patient and feel at ease with treatments.  I always feel bad about switching dr.s like it is an automatic complaint against them.  I know it isn't.  But I appreciate you saying that it is okay to Doctor shop.  I know I have told people that before, but it is different when it is yourself.  Best of thoughts for everyone battling this. 

                  BillMFl
                  Participant

                    Its called a second opinion. If no atypia at all was seen the odds are very much in your favor. But if you want peace of mind have the slides reviewed by another pathologist.

              Viewing 0 reply threads
              • You must be logged in to reply to this topic.
              About the MRF Patient Forum

              The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

              The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.