Should i be worried??
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Should i be worried??

› Forums › General Melanoma Community › Should i be worried??

  • Post
    • February 4, 2016 at 8:24 pm
    Azcaddyman
    Participant

      OK here's a quick summary of what's going on

       

      I went to my dermatologist to have a large lesion on my neck looked at. Although I was convinced it was melanoma, he insisted I was wrong. He suspected it was a bcc. He did a small shave biopsy. The pathology report showed ssm at least .60mm deep. No mitosis, nothing unusual except regressive changes at the base of the biopsy. I was referred to a surgical oncologist. Because we didn't know the actual depth I was scheduled for a slnb and wle. I went in for my procedure about 3 weeks ago. The lymph node biopsy failed. They couldn't get the radioactive tracer to drain into the lymph system. My surgeon did remove some tissue that showed some pickup of the dye but wasn't sure it was even a lymph node. 

      Last week I went in for a post op follow up. The pathology report from the wle/slnb showed that the tissue was not a lymph node. Although it was cancer free. The "residual" melanoma was .8mm deep. No mitosis. Stage 1a. I was told at that point that since my tumor wasn't deep enough no further testing would take place. 

      Now OK I understand how this works, you can't add the first biopsy to the final excision to determine depth. So this means my true staging info was lost because my dermatologist didn't do the right thing. However, is this important? At first they wanted to do a slnb but when that failed, is it OK to just say I'm OK? Would I be crazy to ask for an ultrasound study of my lymph nodes? My Dr assures me that the chances of spread are so low that there's no need to be concerned. So should I just relax? I get my stitches out next week. That will probably be my last appointment and after that I'm on my own. 

    Viewing 5 reply threads
    • Replies
        • February 4, 2016 at 9:08 pm
        gregor913
        Participant
          I would ask for ultrasound it doesn’t hurt. Good news your only 1a.
          • February 4, 2016 at 9:08 pm
          gregor913
          Participant
            I would ask for ultrasound it doesn’t hurt. Good news your only 1a.
            • February 4, 2016 at 9:08 pm
            gregor913
            Participant
              I would ask for ultrasound it doesn’t hurt. Good news your only 1a.
              • February 4, 2016 at 11:08 pm
              Janner
              Participant

                It is actually possible that 0.8mm is correct.  Because the first biopsy was only a partial biopsy of the lesion, the pathologist most likely indicated the depth from the areas that were not part of the original small shaved biopsy.  True, you have lost the data at that exact location but the rest of the lesion was only 0.8mm deep.

                Some doctors will do ultrasounds, most won't.  You can always ask.  But in general, any stage I person does not have any lymph node monitoring except manual palpations of the basins.  Since stage 1 extends to 2mm, it is probably likely that you are still in the stage 1 category no matter what portion of the staging info was lost.  They would have indicated significant residual melanoma otherwise.

                • February 4, 2016 at 11:08 pm
                Janner
                Participant

                  It is actually possible that 0.8mm is correct.  Because the first biopsy was only a partial biopsy of the lesion, the pathologist most likely indicated the depth from the areas that were not part of the original small shaved biopsy.  True, you have lost the data at that exact location but the rest of the lesion was only 0.8mm deep.

                  Some doctors will do ultrasounds, most won't.  You can always ask.  But in general, any stage I person does not have any lymph node monitoring except manual palpations of the basins.  Since stage 1 extends to 2mm, it is probably likely that you are still in the stage 1 category no matter what portion of the staging info was lost.  They would have indicated significant residual melanoma otherwise.

                    • February 4, 2016 at 11:24 pm
                    Azcaddyman
                    Participant

                      Thanks janner. I was hoping you'd respond. I haven't seen the pathology report myself yet. I'll get a copy next week at my visit. After this I have 1 mole I'm already suspicious of that needs to be checked. It's small but meets all the abcde criteria. Although it hasn't changed much in the past month. It's located next to my first primary (you had commented on a previous post about this already). I'm also possibly looking to have my scar fixed due to a large "dog ear" from the flap closure. Basically they gave me an ugly nipple on my back. Oh and its .88mm deep. I mistyped it at .8

                      • February 4, 2016 at 11:24 pm
                      Azcaddyman
                      Participant

                        Thanks janner. I was hoping you'd respond. I haven't seen the pathology report myself yet. I'll get a copy next week at my visit. After this I have 1 mole I'm already suspicious of that needs to be checked. It's small but meets all the abcde criteria. Although it hasn't changed much in the past month. It's located next to my first primary (you had commented on a previous post about this already). I'm also possibly looking to have my scar fixed due to a large "dog ear" from the flap closure. Basically they gave me an ugly nipple on my back. Oh and its .88mm deep. I mistyped it at .8

                        • February 5, 2016 at 2:56 pm
                        Gene_S
                        Participant

                          I would do a punch biopsy next time and not a shave as it is more likely to get all of the depth so no worry about actual depth.

                          • February 5, 2016 at 2:56 pm
                          Gene_S
                          Participant

                            I would do a punch biopsy next time and not a shave as it is more likely to get all of the depth so no worry about actual depth.

                            • February 5, 2016 at 2:56 pm
                            Gene_S
                            Participant

                              I would do a punch biopsy next time and not a shave as it is more likely to get all of the depth so no worry about actual depth.

                              • February 4, 2016 at 11:24 pm
                              Azcaddyman
                              Participant

                                Thanks janner. I was hoping you'd respond. I haven't seen the pathology report myself yet. I'll get a copy next week at my visit. After this I have 1 mole I'm already suspicious of that needs to be checked. It's small but meets all the abcde criteria. Although it hasn't changed much in the past month. It's located next to my first primary (you had commented on a previous post about this already). I'm also possibly looking to have my scar fixed due to a large "dog ear" from the flap closure. Basically they gave me an ugly nipple on my back. Oh and its .88mm deep. I mistyped it at .8

                              • February 4, 2016 at 11:08 pm
                              Janner
                              Participant

                                It is actually possible that 0.8mm is correct.  Because the first biopsy was only a partial biopsy of the lesion, the pathologist most likely indicated the depth from the areas that were not part of the original small shaved biopsy.  True, you have lost the data at that exact location but the rest of the lesion was only 0.8mm deep.

                                Some doctors will do ultrasounds, most won't.  You can always ask.  But in general, any stage I person does not have any lymph node monitoring except manual palpations of the basins.  Since stage 1 extends to 2mm, it is probably likely that you are still in the stage 1 category no matter what portion of the staging info was lost.  They would have indicated significant residual melanoma otherwise.

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