vlmd1986

Hi there,

It is completely normal for the pathologist to want to review your slides more carefully, given your history of melanoma. The pathologist might even want to have a second set of eyes look at the biposy, which can increase your wait time.

A shave biopsy is adequate for diagnosing skin lesions in manycases–and if it's not adequate, that decision is usually made within a couple of days or so.

I can definitely sympathize with you–I had to wait two weeks for my initial mel diagnosis :/ 

Hope everything goes well for you!

V

Hi there,

It is completely normal for the pathologist to want to review your slides more carefully, given your history of melanoma. The pathologist might even want to have a second set of eyes look at the biposy, which can increase your wait time.

A shave biopsy is adequate for diagnosing skin lesions in manycases–and if it's not adequate, that decision is usually made within a couple of days or so.

I can definitely sympathize with you–I had to wait two weeks for my initial mel diagnosis :/ 

Hope everything goes well for you!

V

Hi there,

It is completely normal for the pathologist to want to review your slides more carefully, given your history of melanoma. The pathologist might even want to have a second set of eyes look at the biposy, which can increase your wait time.

A shave biopsy is adequate for diagnosing skin lesions in manycases–and if it's not adequate, that decision is usually made within a couple of days or so.

I can definitely sympathize with you–I had to wait two weeks for my initial mel diagnosis :/ 

Hope everything goes well for you!

V

Sorry I'm late to this post, but I'm horrified by your experience with your previous dermatologist. As a pathologist-in-training and a fellow melanoma survivor (stage 3a), I cannot believe your dermatologist would make you schedule separate appointments for each biopsy. As soon as I read your initial post, I knew that it was absolutely all about the money. The dermatologist could biopsy all three spots in one $250 visit, or have you come 3 times for $150 each (I made those numbers up, but you get the point!). Obviously the latter situation nets him more money but is WAAAYYYY more inconvenient (and EXPENSIVE) for you. I'm embarrassed that this completely unprofessional physician is a member of my profession. If I were you, I'd report him to the medical board for his lack of professionalism/humanity. And I sincerely hope you never encounter another physician like him! Best of luck with your new derm 🙂

Sorry I'm late to this post, but I'm horrified by your experience with your previous dermatologist. As a pathologist-in-training and a fellow melanoma survivor (stage 3a), I cannot believe your dermatologist would make you schedule separate appointments for each biopsy. As soon as I read your initial post, I knew that it was absolutely all about the money. The dermatologist could biopsy all three spots in one $250 visit, or have you come 3 times for $150 each (I made those numbers up, but you get the point!). Obviously the latter situation nets him more money but is WAAAYYYY more inconvenient (and EXPENSIVE) for you. I'm embarrassed that this completely unprofessional physician is a member of my profession. If I were you, I'd report him to the medical board for his lack of professionalism/humanity. And I sincerely hope you never encounter another physician like him! Best of luck with your new derm 🙂

Sorry I'm late to this post, but I'm horrified by your experience with your previous dermatologist. As a pathologist-in-training and a fellow melanoma survivor (stage 3a), I cannot believe your dermatologist would make you schedule separate appointments for each biopsy. As soon as I read your initial post, I knew that it was absolutely all about the money. The dermatologist could biopsy all three spots in one $250 visit, or have you come 3 times for $150 each (I made those numbers up, but you get the point!). Obviously the latter situation nets him more money but is WAAAYYYY more inconvenient (and EXPENSIVE) for you. I'm embarrassed that this completely unprofessional physician is a member of my profession. If I were you, I'd report him to the medical board for his lack of professionalism/humanity. And I sincerely hope you never encounter another physician like him! Best of luck with your new derm 🙂

Hi LMN,

My stuff got sent to California (UCSF) for a second opinion before any diagnosis was given, so that's COMPLETELY normal/routine. I've also read several other stories of peoples' things getting sent to California for a second opinion (usually to UCSF). The Spitz lesions, as Janner mentioned, are incredibly difficult to classify (benign versus kinda bad (Atypical) versus really bad (Malignant Melanoma)), and the Spitz experts are at UCSF. 

It didn't take 2-3 weeks for me to get my results back from UCSF (it was more like 1 week), so hopefully that will be the case for you as well. My advice to you would be to stop thinking about the path results and continue to be actively grateful that you have so many doctors looking out for you and trying to arrive at the most accurate diagnosis. Trust me, there will be plenty of time after the report is finalized for you to think about/obsess over the diagnosis 😉

Have a great day,

VL

Hi LMN,

My stuff got sent to California (UCSF) for a second opinion before any diagnosis was given, so that's COMPLETELY normal/routine. I've also read several other stories of peoples' things getting sent to California for a second opinion (usually to UCSF). The Spitz lesions, as Janner mentioned, are incredibly difficult to classify (benign versus kinda bad (Atypical) versus really bad (Malignant Melanoma)), and the Spitz experts are at UCSF. 

It didn't take 2-3 weeks for me to get my results back from UCSF (it was more like 1 week), so hopefully that will be the case for you as well. My advice to you would be to stop thinking about the path results and continue to be actively grateful that you have so many doctors looking out for you and trying to arrive at the most accurate diagnosis. Trust me, there will be plenty of time after the report is finalized for you to think about/obsess over the diagnosis 😉

Have a great day,

VL

Hi LMN,

My stuff got sent to California (UCSF) for a second opinion before any diagnosis was given, so that's COMPLETELY normal/routine. I've also read several other stories of peoples' things getting sent to California for a second opinion (usually to UCSF). The Spitz lesions, as Janner mentioned, are incredibly difficult to classify (benign versus kinda bad (Atypical) versus really bad (Malignant Melanoma)), and the Spitz experts are at UCSF. 

It didn't take 2-3 weeks for me to get my results back from UCSF (it was more like 1 week), so hopefully that will be the case for you as well. My advice to you would be to stop thinking about the path results and continue to be actively grateful that you have so many doctors looking out for you and trying to arrive at the most accurate diagnosis. Trust me, there will be plenty of time after the report is finalized for you to think about/obsess over the diagnosis 😉

Have a great day,

VL

Janner,

I agree with you (about not seeing an oncologist yet), IF she is, indeed Stage Ia/Ib. However, I didn't see any information in her post to indicate her current stage, so we don't know if she has active disease or not.

However, the fact that she was referred to a plastic surgeon is either 1. Overkill, or 2. Indicative of a concerning lesion (perhaps Stage II MM) that is going to require larger margins upon re-excision. (In which case, having a plastic surgeon do the procedure could be of great benefit cosmetically.) 

Hope all is well, 

V

Janner,

I agree with you (about not seeing an oncologist yet), IF she is, indeed Stage Ia/Ib. However, I didn't see any information in her post to indicate her current stage, so we don't know if she has active disease or not.

However, the fact that she was referred to a plastic surgeon is either 1. Overkill, or 2. Indicative of a concerning lesion (perhaps Stage II MM) that is going to require larger margins upon re-excision. (In which case, having a plastic surgeon do the procedure could be of great benefit cosmetically.) 

Hope all is well, 

V

Janner,

I agree with you (about not seeing an oncologist yet), IF she is, indeed Stage Ia/Ib. However, I didn't see any information in her post to indicate her current stage, so we don't know if she has active disease or not.

However, the fact that she was referred to a plastic surgeon is either 1. Overkill, or 2. Indicative of a concerning lesion (perhaps Stage II MM) that is going to require larger margins upon re-excision. (In which case, having a plastic surgeon do the procedure could be of great benefit cosmetically.) 

Hope all is well, 

V

Hi there,

Usually if the depth is >1mm (or >0.75mm, depending on other characteristics of the lesion), the patient is referred to a surgical oncologist for a wide local excision (getting more tissue out at the site of the original lesion) and sentinel lymph node biopsy (SLNB, to see if the melanoma cells have traveled to the lymph nodes). I'm not aware of plastic surgeons doing SLNBs, so if you are at all uncomfortable with the plan as prescribed, I would suggest that you schedule an appointment with a surgical oncologist.

Hope this helps!

V

Hi there,

Usually if the depth is >1mm (or >0.75mm, depending on other characteristics of the lesion), the patient is referred to a surgical oncologist for a wide local excision (getting more tissue out at the site of the original lesion) and sentinel lymph node biopsy (SLNB, to see if the melanoma cells have traveled to the lymph nodes). I'm not aware of plastic surgeons doing SLNBs, so if you are at all uncomfortable with the plan as prescribed, I would suggest that you schedule an appointment with a surgical oncologist.

Hope this helps!

V

Hi there,

Usually if the depth is >1mm (or >0.75mm, depending on other characteristics of the lesion), the patient is referred to a surgical oncologist for a wide local excision (getting more tissue out at the site of the original lesion) and sentinel lymph node biopsy (SLNB, to see if the melanoma cells have traveled to the lymph nodes). I'm not aware of plastic surgeons doing SLNBs, so if you are at all uncomfortable with the plan as prescribed, I would suggest that you schedule an appointment with a surgical oncologist.

Hope this helps!

V