I recently had a mole shave biopsied. It was my first experience with any changing mole (I'm 45). It started feeling like there was a pimple underneath it and it got reddish. By the time I saw dermatology (about 8 days later), the symptoms were fading — discomfort was gone, redness was gone, though the original mole was a still a bit raised at that point. I have no known family history of melanoma.
The shave biopsy came back as "Compound melanocytic nevus with congenital features and mild to moderate junctional atypia. Junctional atypia focally extends to the margin."
I was sent to dermatology surgery for excision. The surgeon told me these rarely turn into melanomas but that hte standard is to excise. When I asked about the reasons, he told me that when they get into that "moderate" range they like to remove them, and that they also wouldn't want me to forget about the spot and not notice changes in the future.
I did my own research and what I'm finding is studies that suggest the outcomes for moderate atypia are similar to mild in that they don't turn into melanomas, whether excised or not. Further, recurrence of the atypia is low (4%). (for example, this, this, and this).
Am I missing some research that conflicts with these conclusions? I understand that the conclusions in these studies aren't absolute — that they can't say there isn't any risk, but they do seem to suggest that risk is pretty low of just observing plus annual skin exams rather than excision.
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