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Biopsy report

Forums General Melanoma Community Biopsy report

  • Post
    melanooo
    Participant

      Hello,

      New to the site. Just got a biopsy report and am trying to digest the implications and path forward. Report says following:

      Skin, Left superior parietal scalp, biopsy-

      Invasive melanoma, clark's level IV(at least), breslow depth 4.01mm, involving the deep margin.

      Tumor table:

      Procedure- biopsy

      specimen laterality- left

      tumor site- superior parietal scalp

      maximum tumor thickness-specify: 4.01millimeters

      anatomic level (clarks level)- IV (at least)

      ulceration- present

      Margins- peripheral margins: not involved

      Deep margins: involved

      Mitotic rate- 2/mm2

      Microsaellitosis- absent

      Lymphovascular invasion-present

      Perineural invasion- absent

      tumor infiltrating lymphocytes- present, brisk

      pathologic staging-pT4b Nx Mx

       

      Now what?  I'm in Florida and have been told to look into Moffett in Tampa. Thanks for any insight.

       

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    • Replies
        Lucygoose
        Participant

          Hello

          first – I know you’re processing a lot   I’m newly diagnosed too.  Take a deep breath and know that melanoma treatment has made amazing progress in the past few years and it continues to advance. Be careful of searching for survival rates in the internet because they may not reflect the newest treatments  

          you need to see an oncologist who specializes in melanoma.  I don’t know Florida cancer treatment centers.  Who recommended Moffett?  Is it someone you trust?

          I would think you need a PET scan and brain MRI, and a sentinel lymph node biopsy, plus surgery to remove the primary. While your doing that at Moffett, maybe find a second opinion place such as MD Anderson, Sloan Kettering or even Melanoma WorkingGroup at Emory in Atlanta (closer to you). 

          There are also second opinion options with companies such as ‘Grand Rounds’ who can give you ratings of doctors and treatment centers in your area, and can take the scans, etc. performed at your treatment center and have another doctor review the suggested treatment plan. 

          Best of luck to you.  L

            melanooo
            Participant

              Thanks for the reply Lucygoose. Moffet was recommended by my dermatologist as the area experts. Unfortunately they are not "in network" on my high deductible insurance but I am going to talk to them anyway. Will have to research Grand Rounds.  Thanks for the perspective and good luck to you.

            desmelwife
            Participant

              Hello!

              I am new to this site also. My husband has Desmoplastic Melanoma – a very rare subtype of Melanoma. We are in Orlando and could not find any oncologists here that had any experience with this Melanoma. We ended up going to Moffitt because they do. They are very active with clinical trials and ha w some amazing doctors. We have been seeing Dr. Grossman but he is getting ready to move to Utah so we will be transferring to Dr. Eroglu. 

              Melanoma treatment has come a long way in the last several years! 

              Please let me know if I can answer any further questions for you about Moffitt. 

              Tania

              p.s. I have been trying to post my intro on this board for the last several days and keep getting an error message. Can anyone help me??

              Bubbles
              Participant

                Hi Melan,

                Sorry you are dealing with this.  You are probably looking a WLE (wide local excision) around the site of your lesion as well as a sentinel node biopsy of the first node a tracer element reaches when injected at the site of your now removed lesions.  As I'm sure all this sounds like a foreign language, I will share a primer I put together that may help if you are interested:

                https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2017/08/melanoma-intel-primer-for-current.html  

                The treatments noted are more for Stage III/IV patients than your current position and I hope it stays that way!!  However, it will help you get used to the language and there is a link to common melanoma acronyms at the bottom.

                I am sorry you need their services, but I agree with Tania's recommendation of Moffitt.  I traveled there from Chattanooga, TN for over 3 years, starting in 2010, when I participated in a Phase 1 clinical trial with nivolumab, now called Opdivo, for Stage IV melanoma.  The service and expertise were essential.  Now, adequate melanoma services are much more prevalent in local offices and hospitals as some immunotherapy and targeted therapy drugs for melanoma began to gain FDA approval in 2011.  Still, getting a start at Moffitt is probably well advised…and then you can go from there.

                Perhaps the best news….despite being Stage IV with brain and lung mets in 2010, I am still here and remain NED (no evidence of disease) for melanoma with no further treatment since my nivo trial!  There is hope.  Hang in there, all of you.  Yours, celeste

                  melanooo
                  Participant

                    Thank you Celeste, your story/results are very uplifting. Thanks for the primer link also. will spend some time digesting. Still trying to catch my breath after the last 24 hours with the diagnosis….. I will definitely go to Moffitt for initial consult.

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