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Mole on wife’s foot just tested positive for melanoma.
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Mole on wife’s foot just tested positive for melanoma.

› Forums › Cutaneous Melanoma Community › Mole on wife’s foot just tested positive for melanoma.

  • Post
    • February 23, 2018 at 4:53 pm
    Aregowe
    Participant
      Hello all, new here. Wife was just diagnosed yesterday. The sheet she got from the Dr says:

      Malignant melanoma, Breslows depth: 0.55 (at least), Clark’s level: 3 (at least).

      Primary tumor: pT1a (<1.0mm - without ulcer and < 1 mitoses/mm2). Fluorescence in situ hybridization / molecular results abnormal. Not sure what all of that means. But on the 1st they're going to cut deeper into her foot, in a football shape they said, around where they had initially cut. Anyone able to explain what any of this means? I'm kind of freaking out because this sounds terrifying.

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        • February 23, 2018 at 6:11 pm
        Janner
        Participant

          Where are you located?  Typically a SLNB (sentinel lymph node biopsy) is done when a lesion is 0.8mm or larger.  A SLNB checks the first lymph node in the chain to see if any melanoma cells have traveled there.  While your wife's lesion is only 0.55mm, the biopsy bisected the lesion and left melanoma behind.  You don't actually know the real depth of the lesion – and it may be deeper.  (It may not be deeper, that is also a possibility).   So the issue is this – if you want to have them check the lymph nodes to see if this has spread further, that has to be done PRIOR to the surgery for the "football shape" cut.  That is called a WLE – wide local excision.   The WLE may alter the drainage paths.  The SLNB is only a reliable test if it is done prior to the WLE.  So again, if you want to test the lymph nodes, you should make sure that the SLNB is included in the surgical plan for the 1st.  Consider reading up on the Sentinel Lymph Node Biopsy to see if it is what you'd like to consider.

          As far as the rest of the information, the melanoma does have good (if you can call it that) factors.  No ulceration is good.  <1 mitosis is what you want to see.    These factors are positive, it is only the depth that is questionable because the biopsy did not get the entire depth – and depth is the most important prognostic indicator for a melanoma primary.

           

            • February 23, 2018 at 6:38 pm
            Aregowe
            Participant

              We're in Ohio, they did say that they want to do a "body scan", didn't say what that means – could be in reference to an SLNB, not sure. 

              • February 23, 2018 at 7:25 pm
              Janner
              Participant

                That sounds more like doing a full body visual inspection for other suspicious lesions.  Any type of imaging scans aren't typically done for a stage 1 lesion.  They would probably only be done if the SLNB came back positive.  Again, this may be something you have to bring up if you want it done as the initial depth of 0.55mm is under the normal cutoff.   The SLNB would most likely be negative, but as the depth is unknown, the possibility exists is could be positive. 

                Just trying to give you the full picture so you can make an informed decision.  Again, research SLNB for more info.  For reference, my 3rd melanoma was .88mm with a clean deep margin.  At the time, the cutoff was 1.0mm.  My institution didn't do it for my depth of lesion and they didn't discuss it with me.  I only found out afterward.  For me, it turned out fine because that was 15+ years ago.  I only found out about the SLNB after it was too late to do it.  I don't regret it, but I still think it's nice to understand all the options.  I wouldn't have even mentioned it in this posting had the deep margin not been involved in your wife's case.

              • February 27, 2018 at 3:31 pm
              Gene_S
              Participant

                Are you seeing a melanoma specialist?

                 

                  • February 27, 2018 at 11:26 pm
                  Jenna
                  Participant

                    Hi there, 

                    Firstly, I am really sorry to hear about this. I was diagnosed with Stage 1 Melanoma on my ankle last month, and thankfully after a 2nd procedure it is all gone! 

                    I asked my cancer specialist nurse to explain a little about it to me, this is what is said…

                    The most important prognostic indicator is the thickness 'Breslow thickness' of the tumour removed. There was no cell division, thats good and no ulceration, also good. The Breslow thickness was 0.45 mm, under 1mm is good too. This is similar to what you have said above, so hopefully that is a bit of reassurance. 

                    I hope all goes well

                     

                     

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