IMPORTANT QUESTION
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IMPORTANT QUESTION

› Forums › Cutaneous Melanoma Community › IMPORTANT QUESTION

  • Post
    • December 11, 2017 at 3:42 pm
    John Bruno 2613
    Participant

      Hello, everyone, I have a quick question here is some background info. 

       

      My brother had a right mid paraspinal: malignant melanoma without ulceration, Clark level 3, 0.45 mm in Breslow Thickness, with a mitotic index of 0 (pT1a). He had this 1 year ago December 2016. 

      In August he had a Right neck: compound nevus with severe atypia. The examined edges were uninvolved. Re-excision was recommended. Early or evolving malignant melanoma in situ could not be ruled out. 

      Now my brother has a right posterior shoulder: irritated compound nevus, congenital type, focally extending to the deep edge of the specimen. They are saying no further treatment is necessary even though there are cells left from the first excision. Should we re-excise, because we are worried that if we leave the cells being that there is no mole there anymore it would be hard to monitor any changes and the cells may become bad?

      What would you guys recommend to re-excise or not? 

      Thanks so much 

      John

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    • Replies
        • December 12, 2017 at 11:37 pm
        Janner
        Participant

          It's a benign irritated mole.  Congenital nevus so there from an early age.  If it hadn't changed now and was still benign, I wouldn't give it a second thought.  The medical team has said it is fine.  Most doctors do not re-excise benign moles.  Your brother has to do what makes him comfortable.

            • December 17, 2017 at 1:20 am
            John Bruno 2613
            Participant

              I understand what you're saying, but my brother had two melanomas in less than a year. He is getting check every two months at Mayo Clinic and he had several atypical moles (more than 10) It says that people who have more than 10 are 12 times the risk of developing melanoma compared with the general population. When you leave a cell on a person like my brother that you cannot monitor. I think it might be a bad choice since begin moles can turn to melanomas. Leaving a cell in the deep margins are not good because by the time you spot something wrong it could be too late. That is the way I am asking someone with experience with what my bother is going through to please reply. Thank You

              • December 17, 2017 at 5:52 pm
              Janner
              Participant

                Benign lesions are unlikely to EVER become melanoma.  It's the atypical ones.  And 10 atypical moles in not the hundreds that some people have.  I've had 3 melanomas and if I had a benign biopsy, I wouldn't have a re-excision.  I would, however, ask that the doctor NOT do shave biopsies in the future to avoid this very issue.  Shave biopsies can bisect a lesion and you want it all taken the first time.  Then you can decide if you need additional margins.  There are tons of changes that have to happen for a benign mole to beome melanoma and basically, it is so much more likely to happen with a mole that is already atypical – especially severely atypical!  Have the doctor do a proper biopsy technique that assures that the deep margin will not be left behind.  As for the re-excision, you seem to want it but what does your brother want?  I wouldn't but that's me.

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