› Forums › General Melanoma Community › Newly diagnosed and pregnant need advice
- This topic has 15 replies, 3 voices, and was last updated 9 years, 11 months ago by
Janner.
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- March 20, 2016 at 1:07 am
About a month ago I noticed a tiny freckle-like brown mole on the top of my foot had developed a very black dot on it. Went in for biopsy and came back as melanoma in situ. Two days later I find out I'm pregnant. My concern is regarding the biopsy, the dr said they didn't get clear margins and regardless I need to have a wide excision. I will have my excision Tuesday exactly two weeks after the biopsy was done. My fear is that because of my pregnancy (hormones and immunity being suppressed) that during the past two weeks the remaining melanoma has spread. Obviously I don't know how the mechanism of spread works but is there any way that the residual melanoma has turned into something deeper during this time frame??
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- March 20, 2016 at 1:39 am
No. Melanoma in situ is confined to the epidermis. The epidermis doesn't have lymph or blood vessels and that is how melanoma spreads. It isn't considered an issue to wait for a wide excision no matter the depth. Chances are you wont even have any residual melanoma seen in the WLE. In situ means the lesion is growing horizontally on the surface, not downward. (Radial vs vertical growth). I get the hormones and the worry but honestly, I don't think you should worry about any residual melanoma (easy to say, hard to do).
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- March 22, 2016 at 5:48 pm
Thank you for your response, it helped me feel more at ease while I waited for the wider excision. I had the excision today, and I also got an opportunity to see my pathology report. Apparently what was done was a shave biopsy initially. I had specifically told the doctor to please use a technique that would ensure the whole mole would be out. My question is, does a shave accurately let the pathologist determine if it is an in-situ or is there a risk that the shave prevented them from seeing if I actually had a stage I melanoma?
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- March 22, 2016 at 5:48 pm
Thank you for your response, it helped me feel more at ease while I waited for the wider excision. I had the excision today, and I also got an opportunity to see my pathology report. Apparently what was done was a shave biopsy initially. I had specifically told the doctor to please use a technique that would ensure the whole mole would be out. My question is, does a shave accurately let the pathologist determine if it is an in-situ or is there a risk that the shave prevented them from seeing if I actually had a stage I melanoma?
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- March 22, 2016 at 9:25 pm
Shave biopsies are fine as long as the deep margin is clear. There is no problem diagnosing from a shave biopsy itself, the issue with shaves is they are often not very deep and may not remove the entire lesion. They might bisect the lesion. That is not particularly concerning if the lesion is benign, but if the lesion is melanoma, you lose important staging information. You can never know the true depth of a lesion if the biopsy bisects it.
All biopsies go deeper than the epidermis – even shaves. So there is absolutely no issue in your case. But if the diagnoses were a deeper melanoma, the shave might be an issue then.
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- March 22, 2016 at 9:25 pm
Shave biopsies are fine as long as the deep margin is clear. There is no problem diagnosing from a shave biopsy itself, the issue with shaves is they are often not very deep and may not remove the entire lesion. They might bisect the lesion. That is not particularly concerning if the lesion is benign, but if the lesion is melanoma, you lose important staging information. You can never know the true depth of a lesion if the biopsy bisects it.
All biopsies go deeper than the epidermis – even shaves. So there is absolutely no issue in your case. But if the diagnoses were a deeper melanoma, the shave might be an issue then.
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- March 22, 2016 at 9:25 pm
Shave biopsies are fine as long as the deep margin is clear. There is no problem diagnosing from a shave biopsy itself, the issue with shaves is they are often not very deep and may not remove the entire lesion. They might bisect the lesion. That is not particularly concerning if the lesion is benign, but if the lesion is melanoma, you lose important staging information. You can never know the true depth of a lesion if the biopsy bisects it.
All biopsies go deeper than the epidermis – even shaves. So there is absolutely no issue in your case. But if the diagnoses were a deeper melanoma, the shave might be an issue then.
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- March 22, 2016 at 5:48 pm
Thank you for your response, it helped me feel more at ease while I waited for the wider excision. I had the excision today, and I also got an opportunity to see my pathology report. Apparently what was done was a shave biopsy initially. I had specifically told the doctor to please use a technique that would ensure the whole mole would be out. My question is, does a shave accurately let the pathologist determine if it is an in-situ or is there a risk that the shave prevented them from seeing if I actually had a stage I melanoma?
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- March 20, 2016 at 1:39 am
No. Melanoma in situ is confined to the epidermis. The epidermis doesn't have lymph or blood vessels and that is how melanoma spreads. It isn't considered an issue to wait for a wide excision no matter the depth. Chances are you wont even have any residual melanoma seen in the WLE. In situ means the lesion is growing horizontally on the surface, not downward. (Radial vs vertical growth). I get the hormones and the worry but honestly, I don't think you should worry about any residual melanoma (easy to say, hard to do).
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- March 20, 2016 at 1:39 am
No. Melanoma in situ is confined to the epidermis. The epidermis doesn't have lymph or blood vessels and that is how melanoma spreads. It isn't considered an issue to wait for a wide excision no matter the depth. Chances are you wont even have any residual melanoma seen in the WLE. In situ means the lesion is growing horizontally on the surface, not downward. (Radial vs vertical growth). I get the hormones and the worry but honestly, I don't think you should worry about any residual melanoma (easy to say, hard to do).
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- March 21, 2016 at 7:03 pm
I’m so sorry to hear about your diagnosis! But out of any possible melanoma diagnosis, you absolutely have the BEST possible prognosis. As Janner said, in situ is only involving the outermost layer of skin, so it hasn’t spread through the lymphatic system. Waiting 2 weeks for the WLE is a normal amount of time, and not enough time for spread.I would say, though, to let everyone know that you’re pregnant before the WLE. Hopefully they can do the procedure with just local anesthetic, but some offices like to give some “relaxing” medicine beforehand, and this can be harmful to the baby. Also, during your pregnancy be extra vigilant about skin checks. There have been links between the high estrogen level associated with pregnancy and melanoma. You’ve already shown to be susceptible, so keep an eye out! But truly, you have more important things to worry about than your melanoma – like being a mama! 😉
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- March 21, 2016 at 7:03 pm
I’m so sorry to hear about your diagnosis! But out of any possible melanoma diagnosis, you absolutely have the BEST possible prognosis. As Janner said, in situ is only involving the outermost layer of skin, so it hasn’t spread through the lymphatic system. Waiting 2 weeks for the WLE is a normal amount of time, and not enough time for spread.I would say, though, to let everyone know that you’re pregnant before the WLE. Hopefully they can do the procedure with just local anesthetic, but some offices like to give some “relaxing” medicine beforehand, and this can be harmful to the baby. Also, during your pregnancy be extra vigilant about skin checks. There have been links between the high estrogen level associated with pregnancy and melanoma. You’ve already shown to be susceptible, so keep an eye out! But truly, you have more important things to worry about than your melanoma – like being a mama! 😉
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- March 21, 2016 at 7:03 pm
I’m so sorry to hear about your diagnosis! But out of any possible melanoma diagnosis, you absolutely have the BEST possible prognosis. As Janner said, in situ is only involving the outermost layer of skin, so it hasn’t spread through the lymphatic system. Waiting 2 weeks for the WLE is a normal amount of time, and not enough time for spread.I would say, though, to let everyone know that you’re pregnant before the WLE. Hopefully they can do the procedure with just local anesthetic, but some offices like to give some “relaxing” medicine beforehand, and this can be harmful to the baby. Also, during your pregnancy be extra vigilant about skin checks. There have been links between the high estrogen level associated with pregnancy and melanoma. You’ve already shown to be susceptible, so keep an eye out! But truly, you have more important things to worry about than your melanoma – like being a mama! 😉
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Tagged: cutaneous melanoma
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