sdthomas

Just a litle over a month ago I was where you are now.  I was diagosed with malignant melanoma (mine is on my right flank near my beltline) where I had a mole that changed and went bad over time.  Unlike you though I had an exisional biopsy with margins about 1cm that came back as clear. As other people have said its all about getting it staged and the greatest influence on that is the Breslow depth. My melanoma was just over 1 mm in depth, a thin melanoma with no ulceration and a low mitotic rate like yours. The prognosis at that point is still very good.  Unfortunately based on the current treatment guidelines and standard of care it was just deep enough to not be classed as In SITU, where the original biopsy would  have been sufficient. So I was referred to a Surgical Onclogist and on April 20th (about 10 days ago had WLE and SNLB) the pathology report just came back negative on the lymph node. I know you are apprehensive, its a hard thing to find out you have cancer and especially one that is dangerous like melanoma. All indications thought are that you are Stage I which has an excellent prognosis. I can imagine that all sorts of things are running though your head and that they are very scary, I know that they were running though mine. But I want you to be positive and not worry too much until you have all the facts. The hard thing is waiting. Line the previous poster wrote they are probably going to suggest that you get at least a WLE with 1cm margins and go from there. If it turns out that your tumor is thinner than about 0.80 mm they are not likely going to recommend SLNB because there is no clinical evidence that supports that survival rates with thin tumors less than 1mm are any better with doing SNLB than without doing it.  You are talking here of having rates that are close to 97% -98% anyway and trying to improve on that with SNLB.

I just finished treatment for malignant melanoma. I had a mole on my flank above my beltline that I have had for awhile change color and develop a scaly appearance. I went to the dermatologist expecting it to be nothing but after he examined it he decided it looked suspect enough to biopsy it. As I said it turned out to be melanoma.  Luckily it was diagonsed as "thin" and in Stage I, just slightly over 1mm in depth with no ulceration. My dematologist took about a 1cm biopsy and the report came back with good surgical margins meaning no visible cancer spreading beyond the borders of the original biopsy site. Because of the vertical depth of the cancer, it was noted in the pathology report to have spread into the second layer of dermis and not just confined to the upper layer of the epidermis. Based on the pathology report they recommeded a wider excsion to remove more healthy tissue around the original lesion site and a Sentinal Lymphnode Biopsey to check if cancer cells where pasing into the lymphatic system. This is the primary means (its thought) that if melanoma is going to spread it will travel. Anyway, if the tumor is > 1mm deep the current guidelines recommend  Sentinal Lymphnode Biopsy.  So I was referred to a surgical oncologist and had the proceedure (WE + SNLB) performed about 10 days ago at University Hospital in Tucson AZ. You mentioned that you have had a shave biopsy that told you that you have Melanoma, unfortunately they cannot tell you what stage it is from that nor recommend a treatment plan unti they know how deep into the skin it reaches. Unlike other types of skin cancer at a minimum you can probably expect the surgeon or dematologist to want to do an excisional biopsy of at least 1cm to determine how deep into the skin the melanoma is.