› Forums › General Melanoma Community › Newly diagnosed and not sure what’s going on
- This topic has 30 replies, 5 voices, and was last updated 9 years, 11 months ago by
Janner.
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- January 4, 2016 at 7:13 pm
I received a diagnosis of melanoma last week and have been lurking since. I was told it was a 0.8 mm superficial spreading and they were sending me to a surgical oncologist.
I was too shocked to ask questions because I honestly didn't expect the biopsy to be anything other than an atypical mole. Right now I'm waiting for the surgeon's office to call me about a wide margin excision and a SNLB.
I did get a copy of the pathology report and now I'm even more confused. It looks like it's not 0.8 mm, but at least 0.8 mm. How concerned should I be or this just a random atypical thing that happens in thin to moderate melanoma?
MELANOMA; EXTENDING TO THE SIDE AND DEEP TISSUE EDGES. Type: Superficial spreading Tumor (Breslow) thickness (mm): 0.8, at least Anatomic level of invasion (Clark level): III, at least Ulceration: Absent Dermal mitotic rate (mitoses/mm2): 2 Microsatellitosis: Not identified Vertical growth phase: Present Regression: Not identified Angiolymphatic invasion: Not identified Neurotropism: Not identified Tumor infiltrating lymphocytes: Non-brisk Precursor lesion: Nevus Pathologic stage: pT1b. Comment: This is a difficult case with borderline features. Sections show a proliferation of atypical melanocytes in the epidermis and dermis. The junctional component is disposed in a confluent fashion with adnexal extension. The dermal component is present in aggregates with variable maturation. Nests of bland nevoid melanocytes are also present, consistent with a component of nevus. As these are intermingled with dermal melanoma cells, depth of invasion is difficult to precisely assess in this specimen.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 5:44 am
Hi – I don't have much advice for you, but just wanted to acknowledge that it must be very difficult for you to cope with the uncertainty of that pathology report, but soon enough (after WLE, and the precautionary SNLB) you will have some clarity. There are others far more knowledgable than me about pathology reports, some can give probably tell you what each and every one of those listed items mean. One thing I've heard others recommend, and it's great advice, is to get a second opinion on the pathology, preferably through an expert melanoma centre (I think they can send the actual pathology slides or images over and get a 'second read' for accuracy). I think in the world of melanoma you are lucky enough to still have what would be regarded as a thin lesion with a very good prognosis. You are not alone, there is good news amongst the uncertainty, and there's a whole heap of new therapies around if needed.
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- January 5, 2016 at 6:35 am
I’ll start off up front that I’m no expert on pathology. I’m curious as to what type of biopsy was performed. My case is nearly identical. I’m scheduled for my wle and slnb next week. In my case there was only a shave biopsy performed and that’s why they couldn’t get an accurate measurement of depth. My margins weren’t clear in any direction in the biopsy, although I show signs of regression throughout the sampled tissue. Otherwise nearly identical results. It looks like your melanoma is coming from a mole that didn’t start out bad. That’s why there’s a mixed result. Your biopsy shows both a regular (or atypical) mole and melanoma cells. My question really is why your pathology report states no ulceration yet has it listed as 1b… I wish you the best. Remember there’s many of us here going through this and many more who have already been here done that. My motto right now is there’s nothing to worry about, until it’s time to worry. Just stay positive. -
- January 5, 2016 at 6:35 am
I’ll start off up front that I’m no expert on pathology. I’m curious as to what type of biopsy was performed. My case is nearly identical. I’m scheduled for my wle and slnb next week. In my case there was only a shave biopsy performed and that’s why they couldn’t get an accurate measurement of depth. My margins weren’t clear in any direction in the biopsy, although I show signs of regression throughout the sampled tissue. Otherwise nearly identical results. It looks like your melanoma is coming from a mole that didn’t start out bad. That’s why there’s a mixed result. Your biopsy shows both a regular (or atypical) mole and melanoma cells. My question really is why your pathology report states no ulceration yet has it listed as 1b… I wish you the best. Remember there’s many of us here going through this and many more who have already been here done that. My motto right now is there’s nothing to worry about, until it’s time to worry. Just stay positive. -
- January 5, 2016 at 6:35 am
I’ll start off up front that I’m no expert on pathology. I’m curious as to what type of biopsy was performed. My case is nearly identical. I’m scheduled for my wle and slnb next week. In my case there was only a shave biopsy performed and that’s why they couldn’t get an accurate measurement of depth. My margins weren’t clear in any direction in the biopsy, although I show signs of regression throughout the sampled tissue. Otherwise nearly identical results. It looks like your melanoma is coming from a mole that didn’t start out bad. That’s why there’s a mixed result. Your biopsy shows both a regular (or atypical) mole and melanoma cells. My question really is why your pathology report states no ulceration yet has it listed as 1b… I wish you the best. Remember there’s many of us here going through this and many more who have already been here done that. My motto right now is there’s nothing to worry about, until it’s time to worry. Just stay positive.-
- January 5, 2016 at 12:45 pm
That is a great motto! And yes, from what I understand, a mitotic rate of over 1 is considered 1B. But I'm at a 2, which probably isn't great but it could be worse as far as rates go. That means the cancer cells aren't growing at a super-rapid rate, right?
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- January 5, 2016 at 12:45 pm
That is a great motto! And yes, from what I understand, a mitotic rate of over 1 is considered 1B. But I'm at a 2, which probably isn't great but it could be worse as far as rates go. That means the cancer cells aren't growing at a super-rapid rate, right?
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- January 5, 2016 at 12:45 pm
That is a great motto! And yes, from what I understand, a mitotic rate of over 1 is considered 1B. But I'm at a 2, which probably isn't great but it could be worse as far as rates go. That means the cancer cells aren't growing at a super-rapid rate, right?
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- January 5, 2016 at 12:56 pm
I had a shave biopsy, too, so I'm wondering how much of the melanoma did they actually get. I suppose the WLE will tell me more? And my report doesn't say anything about margins other than the extending to the side and deep edges?
The mole was one I had as long as I remember. I thought it was a birthmark. A couple months ago it started changing, getting darker and larger, which is why I went in. The mix up of cells make sense.
To be honest, up until I saw the report, I was considering not having the SLNB done because for a simple 0.8 mm melanoma, the risk of lymph node involvement seemed really low on the medical studies I read. But reading it over with all the mixed up stuff and borderline features, it makes sense to do it now.
And again, love the motto. I'm trying to act as if the WLE will clear the rest up and the SLNB is just a precaution, because even with the oddness, the chances of SLNB coming back positive is still low.
Good luck on your surgery next week! Stay positive.
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- January 5, 2016 at 12:56 pm
I had a shave biopsy, too, so I'm wondering how much of the melanoma did they actually get. I suppose the WLE will tell me more? And my report doesn't say anything about margins other than the extending to the side and deep edges?
The mole was one I had as long as I remember. I thought it was a birthmark. A couple months ago it started changing, getting darker and larger, which is why I went in. The mix up of cells make sense.
To be honest, up until I saw the report, I was considering not having the SLNB done because for a simple 0.8 mm melanoma, the risk of lymph node involvement seemed really low on the medical studies I read. But reading it over with all the mixed up stuff and borderline features, it makes sense to do it now.
And again, love the motto. I'm trying to act as if the WLE will clear the rest up and the SLNB is just a precaution, because even with the oddness, the chances of SLNB coming back positive is still low.
Good luck on your surgery next week! Stay positive.
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- January 5, 2016 at 12:56 pm
I had a shave biopsy, too, so I'm wondering how much of the melanoma did they actually get. I suppose the WLE will tell me more? And my report doesn't say anything about margins other than the extending to the side and deep edges?
The mole was one I had as long as I remember. I thought it was a birthmark. A couple months ago it started changing, getting darker and larger, which is why I went in. The mix up of cells make sense.
To be honest, up until I saw the report, I was considering not having the SLNB done because for a simple 0.8 mm melanoma, the risk of lymph node involvement seemed really low on the medical studies I read. But reading it over with all the mixed up stuff and borderline features, it makes sense to do it now.
And again, love the motto. I'm trying to act as if the WLE will clear the rest up and the SLNB is just a precaution, because even with the oddness, the chances of SLNB coming back positive is still low.
Good luck on your surgery next week! Stay positive.
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- January 5, 2016 at 3:46 pm
You will never know the exact depth of the lesion. That is the disadvantage of having a shave biopsy – they can bisect a lesion and leave you in staging limbo. The WLE can tell you if there was any melanoma remaining and if it had any significant size. But you can't just "add" anything found there to your 0.8mm. Because of the way the biopsy skin is sliced and diced and the same with the WLE, they can't match up the tissue samples. So your lesion will always be "at least 0.8" with maybe some residual or maybe not.
Your margins were involved all around. That's all they can really say. That influences how big the WLE will be. They know they will have to take at least the typical 1cm margins and maybe more because of your involved margins. All WLEs take the tissue downwards to the muscle fascia but you may have a little more taken on the surface to make sure you get at least 1cm of clean margins.
The SLNB here makes sense because of the lack of an accurate depth measurement. Hopefully, your lesion is really around the same depth as removed. But as you don't know that for certain, it's probably the best way to go for now.
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- January 5, 2016 at 3:46 pm
You will never know the exact depth of the lesion. That is the disadvantage of having a shave biopsy – they can bisect a lesion and leave you in staging limbo. The WLE can tell you if there was any melanoma remaining and if it had any significant size. But you can't just "add" anything found there to your 0.8mm. Because of the way the biopsy skin is sliced and diced and the same with the WLE, they can't match up the tissue samples. So your lesion will always be "at least 0.8" with maybe some residual or maybe not.
Your margins were involved all around. That's all they can really say. That influences how big the WLE will be. They know they will have to take at least the typical 1cm margins and maybe more because of your involved margins. All WLEs take the tissue downwards to the muscle fascia but you may have a little more taken on the surface to make sure you get at least 1cm of clean margins.
The SLNB here makes sense because of the lack of an accurate depth measurement. Hopefully, your lesion is really around the same depth as removed. But as you don't know that for certain, it's probably the best way to go for now.
-
- January 5, 2016 at 3:46 pm
You will never know the exact depth of the lesion. That is the disadvantage of having a shave biopsy – they can bisect a lesion and leave you in staging limbo. The WLE can tell you if there was any melanoma remaining and if it had any significant size. But you can't just "add" anything found there to your 0.8mm. Because of the way the biopsy skin is sliced and diced and the same with the WLE, they can't match up the tissue samples. So your lesion will always be "at least 0.8" with maybe some residual or maybe not.
Your margins were involved all around. That's all they can really say. That influences how big the WLE will be. They know they will have to take at least the typical 1cm margins and maybe more because of your involved margins. All WLEs take the tissue downwards to the muscle fascia but you may have a little more taken on the surface to make sure you get at least 1cm of clean margins.
The SLNB here makes sense because of the lack of an accurate depth measurement. Hopefully, your lesion is really around the same depth as removed. But as you don't know that for certain, it's probably the best way to go for now.
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Tagged: cutaneous melanoma
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