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2nd Pathology Report Stage1a & SLN
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2nd Pathology Report Stage1a & SLN

› Forums › General Melanoma Community › 2nd Pathology Report Stage1a & SLN

  • Post
    • April 29, 2017 at 10:50 pm
    BetsyM1214
    Participant

      I just got back from MDA for a 2nd opinion and have scheduled a WLE & SLN with them on Monday. The surgical oncologist confirmed that I am a 1A BUT offered a SLN. This confused me and I did walk out of there feeling like I did not get an answer as to why I was offered the SLN. I did accept the offer but was hoping for any info from other 1A's that were offered an SLN?

      1st Pathology: .6mm, Clark 2, no mitosis, no regression, no ulceration, 'lesion extends focally to lateral margins & base of biopsy'

      2nd Pathology: only differences are .5mm, Clarks 'early 4, only 1 involved peripheral margin. Deep margin clear. 

      So…. in trying to understand why I was offered the SLN,  I asked if it would be covered by insurance since I'm 1A? Dr said she would emphasize the sentence of the 1st pathology report where it notes the lesion extends to the base of the biopsy.

      I do want the SLN because for me it will hopefully be piece of mind if clear ( I understand never any guarantees). But I just got these results yesterday, booked last minute flights & hotel for WLE & SLN tomorrow and am now concerned that 1. my insurance won't cover it, 2. the doctor wasn't being fourthcoming with my prognosis when she said '99% certain this will not recur' or my staging at 1A. Lastly, I'm a 34yo Female and was diagnosed shortly after my 2nd baby was born.  Thanks all!

       

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    • Replies
        • April 29, 2017 at 11:17 pm
        jennunicorn
        Participant

          Since the first pathology report is saying it did not remove the entire lesion, there is no way to know the real depth of it, therefore doing an SLNB just to be safe is a good idea. SLNB's typically start at .75mm and up, your pathology being .60mm depth with some left over, it's too close not to do an SLNB. These great docs and their staff are used to dealing with insurance, and I would be surprised if insurance didn't cover the SLNB after hearing the reasoing from a specialist. 

          • April 29, 2017 at 11:57 pm
          MichelleRHG
          Participant
            I second everything Jenn said . I am also a patient at MDA. You will be in good hands!
            • April 30, 2017 at 9:49 am
            stars
            Participant

              Just to clarify: are you the lady who got that first pathology report then got a second opinion on pathology and what you are posting is the second opinion (2nd Pathology)? If so, I think the great news is that your melanoma just got shallower (from 0.6mm to 0.5mm), unfortunately it penetrated deeper into the layers of skin (from Clark 2 to Clark 4) and now they are saying the base wasn't bisected after all but only the peripheral margin was incomplete? All in all I'd say this is good news – the big worry with Pathology 1 (first opinion) was that the lesion extended to the base. This meant depth could not be established, and depth is all important in melanoma. Look, your story just got rosier in my view. Go ahead with teh SLNB if that's what they recommend but if I were you I'd be very happy with these developments.

                • April 30, 2017 at 11:50 am
                Jamie1960
                Participant

                  When in doubt, cut ; if nothing else, you will have peace of mind in the present.

                • April 30, 2017 at 2:52 pm
                Marksa2570
                Participant

                  I am curious.. where on your body was this mole located?        

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