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Shave Biopsy Margin question
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Shave Biopsy Margin question

› Forums › Cutaneous Melanoma Community › Shave Biopsy Margin question

  • Post
    • June 1, 2017 at 6:32 pm
    heatherrenee_c
    Participant

      Hello!

      Last year I had a WLE for a stage 1a melanoma on my left arm.  Now I have another melanoma on my leg they are doing a WLE for on Monday.  This one was tested by a shave biopsy.  My derm said she really didn't expect it to be melanoma but with my history wanted to check on this mole.  My surgeon says he doesn't need to do a SNB because of the thinness (0.48mm) but my questions is how do they know the depth with a shave biopsy?  This is what the path report says in regards to margins: "Atypical intraepidermal melanocytic celis exted to the peripheral edges of the tissue specimen and dermal nevus cells extend to the deep edge of the tissue specimen."

      I plan on asking my surgeon more questions Monday prior to surgery, but wanted to ask here if any one can help explain?  Or help with better questions to ask my surgeon since I always seem to leave with questions unasked! 

       

      Thanks in advance!

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        • June 2, 2017 at 11:44 pm
        Janner
        Participant

          The short answer is they don't.  Since there are cells in the deep margin, there is no way to tell how deep the lesion goes.  Unlikely it is much deeper but the shave biopsy has compromised the depth and you will never know the exact depth.  (They can't just "add" what is already removed to what is left behind – the samples will never match up).  I think it's a very valid question to ask about the SNB – probably totally unnecessary but with cells in the deep margin, you should be given the choice, not told it isn't necessary.

            • June 2, 2017 at 11:46 pm
            Janner
            Participant

              One more thing, if you want the SNB, do NOT have the surgery on Monday.  The SNB has to be done prior to the wide excision.  The WLE may change the drainage paths compromising the SNB.

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