- August 14, 2010 at 4:48 am
Was the degree of atypia specified in the wide excision sample? I think if it were mildly atypical melanocytes, I might be content to monitor the area for any pigment regrowth. If the cells were severely atypical, I would want a re-excision now. I suppose the punch biopsy idea might be ok, but I've never seen that technique mentioned here in the many years I've been on this site. I have had biopsies on my back which is highly freckled and have not had the same issues with atypical cells.
I would ask for a copy of your pathology reports. There are types of melanoma – even for in situ. Lentigo Maligna is one type that is ONLY in situ. It is called Lentigo Maligna Melanoma when it becomes invasive. I have also had an in situ lesion that was considered Superficial Spreading Melanoma. Nodular is rarely found at the in situ stage. So maybe the communication broke down somewhere. The pathology report should clarify that.
In the end, do what makes YOU comfortable. If you want larger margins, then have them. If you are tired of the cutting and are content to watch the area closely for any pigment changes, then do that. YOU drive your care!