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Punch vs Excisional biopsy – Janner?
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Punch vs Excisional biopsy – Janner?

› Forums › General Melanoma Community › Punch vs Excisional biopsy – Janner?

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    • September 15, 2017 at 12:11 am
    kp23
    Participant

      Hi. I posted a few weeks ago with a question about pathology results. A little background – my initial pathology came back as a 'benign lentigo'. I felt anxious due to nature of the spot, even with the benign results…the PA at my dermatologist offered to have their in house dermapathologists take a second look at my slides for my peace of mind. Spoke with the PA tonight..she said that both of their dermapathologists looked at my biopsy and agreed with the initial assessment of a benign lentigo. *However* they also looked at the photos I provided in my chart, and said that "focally, based on the photos, there appeared to be a very slight increase in meloncytes (spelling?) on the surface. They suggested to the PA that she offer me the option of a punch vs excisional biopsy to get more tissue…for my peace of mind. 

      I went ahead and scheduled the punch as the PA has an opening next Friday am vs waiting until the beginning of October for an excisional biopsy. I am wondering if the excisional would be better in case there is something – getting more tissue out of it is something vs a punch that does not remove as much? I asked the PA and she said the only reason she would recommend excisional is that the incision will "look better" and that clinically it does not make a difference.

      I guess I am feeling very worried that the pathologists recommended this? I asked the PA if they were concerned about melanoma, and she said no, it was truly for my peace of mind? But I question if they would suggest that if there is not a clinical indication? I am going to call back in the morning and request a copy of the path report. I do have a copy of the initial path report. 

      Any thoughts on this would be most appreciated. Thank you in advance.

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        • September 15, 2017 at 2:49 am
        Janner
        Participant

          My take – sounds like a lot of overkill if the lentigo they sampled is benign.  There's a very long way to go for even a focal part of it to be lentigo maligna.  I just don't see it.  As for whether a punch or excision is best, I would personally probably have neither.  My take – the pathologists are humoring you and your anxiety.  I most likely would move on but periodically check the area for any pigment regrowth.  If the lesion grows back, I'd consider removing it then.  But with a benign diagnosis, I would not go in and have more tissue taken at this time.  That's what *I* would do – you have to do what makes you happy.

            • September 15, 2017 at 3:18 am
            kp23
            Participant

              Thank you so much for your honest reply. I appreciate you taking the time. 

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