Subsequent Biopsies
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Subsequent Biopsies

› Forums › General Melanoma Community › Subsequent Biopsies

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    • March 14, 2017 at 9:55 pm
    messedmelanocytes
    Participant

    I had two initial biopsies that were in situ last month, they were punch biopsies and followed by WLE.

    Now they want to biopsy 3 additioanl sites, but they won't be punch biopsies, they will go straigh to WLE. I was surprised to learn of this from my doctor today, I can see doing additional biopies but to go straight to WLE was surprising to me.

    Has anyone else been given treatment like that for suspicious sites? I haven't heard that this is typcial.   Do you just continue to have only WLE for every suspected site once you have an insitu?  

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      • March 15, 2017 at 10:53 am
      stars
      Participant

      Are you getting Wide Level Excisions (WLE) mixed up with standard excisional biopsy? A WLE is done after diagnosis and is aimed at removing 0.5mm – 2cm of healthy skin. A standard excisional biopsy – which is what should be done for suspected melanoma, punch biopsies are not recommended and nor are shave biopsies – aims to remove the lesion plus 2mm of healthy skin all around. I think you are getting standard excisional biopsies (which will leave a 2cm or so scar), not a WLE (which is more like a 8-10cm scar). Standard excisional biopsies are what you should get. After two in situs I would demand standard excisional biopsies – no more punch or shave biopsis.

        • March 15, 2017 at 10:54 am
        stars
        Participant

        correction – not 0.5mm, 0.5cm (for WLEs)

        • March 15, 2017 at 3:58 pm
        jennunicorn
        Participant

        Punch biopsies are fine, shaves are not great since it can bisect the lesion not giving a clear indication of depth. My dermatologist who is a melanoma specialist does punch biopsies for small lesions, it's not an issue. Excisional biopsies are good and best for larger diameter lesions.

        • March 16, 2017 at 11:28 am
        stars
        Participant

        I would challenge that. Punches are quick and easy which is why derms love them. They are not the gold standard for suspected melanoma though (not in Australia, at least): See page xxiii of attached – now that I have had melanoma, I will not accept punch or shave biopsies any morel https://www.cancer.org.au/content/pdf/HealthProfessionals/ClinicalGuidelines/ClinicalPracticeGuidelines-ManagementofMelanoma.pdf

        • March 16, 2017 at 1:02 am
        messedmelanocytes
        Participant

        Thank you for your reply, neither doctor menioned the term "standard excisional biopsey" but what you describe makes much more sense. I am relieved that they are probably doing the lesser excision.  

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