› Forums › General Melanoma Community › SNB for Early Stage 1A?
- This topic has 15 replies, 3 voices, and was last updated 10 years, 8 months ago by
Kacey79.
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- September 9, 2014 at 6:19 pm
Hello everyone,
This forum has been a sanity saver for me, and I thank you all for your input. My surgical consult is Friday and am illierate about the "justification" or rationale for sentinal node biopsies. I've looked at other sites and come away with an ambiguous result.
One 7mm area staged 1A by this forum, Clarks level II, shallow thickness 0.25mm. The location is near the shoulder area upper left arm, approximately 1-2 inches from a prior surgical scar (impingement) and 3-4 inches away from the apparent location of lymph node(s) in the underarm area.
Questions: what are the top determing factors for a SNL? Location and depth or something else? Would it be unrealistic or unwise to push for a needle biopsy? Should I be concerned at all? Thanks again.
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- September 9, 2014 at 6:35 pm
The likelihood of a positive SNB is probably <1% for a lesion like yours. Stage IA — it typically is not done. If using depth, 1mm is typically the cutoff (some places use 0.75). In any scenario, your lesion doesn't justify having one. It's surgery, it has complications, and it is no guarantee against future spread. It's a staging tool and it is going to be negative in your case (my prediction only). I, personally, would not do it. There is a reason they have created guidelines for this, because at some point it becomes unnecessary surgery. Your lesion falls within those parameters.
A needle biopsy would not be done. That would be used to determine the makeup of a tumor, it would not be accurate for diagnosing melanoma as a SNB.
Your risk of a new primary is higher than your risk for recurrence from this lesion. Watch moles for change! Watch the scar area for pigment regrowth. And go on and LIVE LIFE! You are most likely done with melanoma…. be vigilant but not paranoid!
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- September 9, 2014 at 6:35 pm
The likelihood of a positive SNB is probably <1% for a lesion like yours. Stage IA — it typically is not done. If using depth, 1mm is typically the cutoff (some places use 0.75). In any scenario, your lesion doesn't justify having one. It's surgery, it has complications, and it is no guarantee against future spread. It's a staging tool and it is going to be negative in your case (my prediction only). I, personally, would not do it. There is a reason they have created guidelines for this, because at some point it becomes unnecessary surgery. Your lesion falls within those parameters.
A needle biopsy would not be done. That would be used to determine the makeup of a tumor, it would not be accurate for diagnosing melanoma as a SNB.
Your risk of a new primary is higher than your risk for recurrence from this lesion. Watch moles for change! Watch the scar area for pigment regrowth. And go on and LIVE LIFE! You are most likely done with melanoma…. be vigilant but not paranoid!
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- September 9, 2014 at 8:57 pm
I was diagnosed in April. The original pathology noted that the tumor depth was 1.30 mm, not ulcerated, and no signs of mitotic activity. I was all squared away for a SNB at Moffitt Cancer Center in Tampa. Their pathologists reviewed my biopsy and actually downgraded me from a 1.30 mm to .3 mm depth melanoma. Apparently the first pathologist included my existing mole within the depth measurement. Eh, I am putting my faith in Moffit. Well with that said, 1 mm makes a BIG difference. I did not have to have a SNB and did have the WLE for my .30 mm melanoma. I was located on my upper left arm. My margins came back clear, thank goodness.
I've had a few more biopsies of exisiting moles that have come back dysplastic. I have to see my dermatologist every 3 months and follow up with Moffit every 6 months. My dermatologist is still urging me to get Total Body Photography of my moles.
Your case sounded a little bit similar to mine and wanted to share my experience with you. Best of luck <3
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- September 9, 2014 at 8:57 pm
I was diagnosed in April. The original pathology noted that the tumor depth was 1.30 mm, not ulcerated, and no signs of mitotic activity. I was all squared away for a SNB at Moffitt Cancer Center in Tampa. Their pathologists reviewed my biopsy and actually downgraded me from a 1.30 mm to .3 mm depth melanoma. Apparently the first pathologist included my existing mole within the depth measurement. Eh, I am putting my faith in Moffit. Well with that said, 1 mm makes a BIG difference. I did not have to have a SNB and did have the WLE for my .30 mm melanoma. I was located on my upper left arm. My margins came back clear, thank goodness.
I've had a few more biopsies of exisiting moles that have come back dysplastic. I have to see my dermatologist every 3 months and follow up with Moffit every 6 months. My dermatologist is still urging me to get Total Body Photography of my moles.
Your case sounded a little bit similar to mine and wanted to share my experience with you. Best of luck <3
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- September 9, 2014 at 8:57 pm
I was diagnosed in April. The original pathology noted that the tumor depth was 1.30 mm, not ulcerated, and no signs of mitotic activity. I was all squared away for a SNB at Moffitt Cancer Center in Tampa. Their pathologists reviewed my biopsy and actually downgraded me from a 1.30 mm to .3 mm depth melanoma. Apparently the first pathologist included my existing mole within the depth measurement. Eh, I am putting my faith in Moffit. Well with that said, 1 mm makes a BIG difference. I did not have to have a SNB and did have the WLE for my .30 mm melanoma. I was located on my upper left arm. My margins came back clear, thank goodness.
I've had a few more biopsies of exisiting moles that have come back dysplastic. I have to see my dermatologist every 3 months and follow up with Moffit every 6 months. My dermatologist is still urging me to get Total Body Photography of my moles.
Your case sounded a little bit similar to mine and wanted to share my experience with you. Best of luck <3
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- September 10, 2014 at 11:16 pm
Kacey79,
Thanks for your reply. It had to be great news to be "downgraded!" It's hard to tell sometimes where to place our trust. Congratulations on a great outcome; no SNB, clear margins. I've learned a lot from everyone here. I never heard of Total Body Photography, but see immediately how it could be extremely useful. It sounds like you have a very concerned and compassionate dermatologist. I wish you all the best for your future checks.
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- September 12, 2014 at 6:53 pm
You're welcome, Resilient4Life. It definitely was a relief to be downgraded. Melanoma is such a scary word and reading the different forum posts I have much respect for those who are fighting the beast. I wish you all the best in your future tests and procedures. 🙂
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- September 12, 2014 at 6:53 pm
You're welcome, Resilient4Life. It definitely was a relief to be downgraded. Melanoma is such a scary word and reading the different forum posts I have much respect for those who are fighting the beast. I wish you all the best in your future tests and procedures. 🙂
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- September 12, 2014 at 6:53 pm
You're welcome, Resilient4Life. It definitely was a relief to be downgraded. Melanoma is such a scary word and reading the different forum posts I have much respect for those who are fighting the beast. I wish you all the best in your future tests and procedures. 🙂
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- September 10, 2014 at 11:16 pm
Kacey79,
Thanks for your reply. It had to be great news to be "downgraded!" It's hard to tell sometimes where to place our trust. Congratulations on a great outcome; no SNB, clear margins. I've learned a lot from everyone here. I never heard of Total Body Photography, but see immediately how it could be extremely useful. It sounds like you have a very concerned and compassionate dermatologist. I wish you all the best for your future checks.
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- September 10, 2014 at 11:16 pm
Kacey79,
Thanks for your reply. It had to be great news to be "downgraded!" It's hard to tell sometimes where to place our trust. Congratulations on a great outcome; no SNB, clear margins. I've learned a lot from everyone here. I never heard of Total Body Photography, but see immediately how it could be extremely useful. It sounds like you have a very concerned and compassionate dermatologist. I wish you all the best for your future checks.
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- September 10, 2014 at 11:08 pm
Thank you Janner, your points were what I was looking for. Especially the risk of recurrence. Very difficult for me to "just" be vigilant without being more.
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- September 10, 2014 at 11:08 pm
Thank you Janner, your points were what I was looking for. Especially the risk of recurrence. Very difficult for me to "just" be vigilant without being more.
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- September 10, 2014 at 11:08 pm
Thank you Janner, your points were what I was looking for. Especially the risk of recurrence. Very difficult for me to "just" be vigilant without being more.
-
- September 9, 2014 at 6:35 pm
The likelihood of a positive SNB is probably <1% for a lesion like yours. Stage IA — it typically is not done. If using depth, 1mm is typically the cutoff (some places use 0.75). In any scenario, your lesion doesn't justify having one. It's surgery, it has complications, and it is no guarantee against future spread. It's a staging tool and it is going to be negative in your case (my prediction only). I, personally, would not do it. There is a reason they have created guidelines for this, because at some point it becomes unnecessary surgery. Your lesion falls within those parameters.
A needle biopsy would not be done. That would be used to determine the makeup of a tumor, it would not be accurate for diagnosing melanoma as a SNB.
Your risk of a new primary is higher than your risk for recurrence from this lesion. Watch moles for change! Watch the scar area for pigment regrowth. And go on and LIVE LIFE! You are most likely done with melanoma…. be vigilant but not paranoid!
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