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Age old question of….Genetic Testing or No?
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Age old question of….Genetic Testing or No?

› Forums › General Melanoma Community › Age old question of….Genetic Testing or No?

  • This topic has 18 replies, 5 voices, and was last updated 8 years ago by m355.
  • Post
    • April 28, 2016 at 7:52 pm
    m355
    Participant

      I have had 2 MIS and one stage 1a.  Derm said it might be a good idea given my history.  No one in my family has had melanoma, well immediate.  My grandmothers father did. So I guess that counts. I do have alot of atypical moles. I mean it would be good to know if this is genetic but at the same time does that increase my worry even more? I am already a worry wart of this stuff.  indecision

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    • Replies
        • April 28, 2016 at 8:02 pm
        Janner
        Participant

          What do you really gain by knowing?  Not much.  You already know you are high risk for other primaries and since you have had melanoma, your family is at higher risk just for that.  Multiple primaries fits the profile unless you have dysplastic nevus syndrome – that's a different type of defect.  But typically you find melanoma in every generation – it doesn't skip.  So your family background doesn't really work.  I have the gene CDKN2A and honestly, there is nothing I do differently because of it.   I only found out because I participated in a clinical trial and wanted to give back to research.  I don't really see the point in knowing.  If there were some treatment advantage to knowing, that would be totally different.  Your mileage may vary.

          • April 28, 2016 at 8:02 pm
          Janner
          Participant

            What do you really gain by knowing?  Not much.  You already know you are high risk for other primaries and since you have had melanoma, your family is at higher risk just for that.  Multiple primaries fits the profile unless you have dysplastic nevus syndrome – that's a different type of defect.  But typically you find melanoma in every generation – it doesn't skip.  So your family background doesn't really work.  I have the gene CDKN2A and honestly, there is nothing I do differently because of it.   I only found out because I participated in a clinical trial and wanted to give back to research.  I don't really see the point in knowing.  If there were some treatment advantage to knowing, that would be totally different.  Your mileage may vary.

              • April 28, 2016 at 9:06 pm
              m355
              Participant

                I do make alot of atypical moles that is for sure.  But nothing crazy, crazy are the normal ones that go rogue. My thoughts exactly if there was to ever be a treatment advantage.

                • April 28, 2016 at 9:06 pm
                m355
                Participant

                  I do make alot of atypical moles that is for sure.  But nothing crazy, crazy are the normal ones that go rogue. My thoughts exactly if there was to ever be a treatment advantage.

                  • April 28, 2016 at 9:06 pm
                  m355
                  Participant

                    I do make alot of atypical moles that is for sure.  But nothing crazy, crazy are the normal ones that go rogue. My thoughts exactly if there was to ever be a treatment advantage.

                  • April 28, 2016 at 8:02 pm
                  Janner
                  Participant

                    What do you really gain by knowing?  Not much.  You already know you are high risk for other primaries and since you have had melanoma, your family is at higher risk just for that.  Multiple primaries fits the profile unless you have dysplastic nevus syndrome – that's a different type of defect.  But typically you find melanoma in every generation – it doesn't skip.  So your family background doesn't really work.  I have the gene CDKN2A and honestly, there is nothing I do differently because of it.   I only found out because I participated in a clinical trial and wanted to give back to research.  I don't really see the point in knowing.  If there were some treatment advantage to knowing, that would be totally different.  Your mileage may vary.

                    • April 28, 2016 at 8:21 pm
                    Mat
                    Participant

                      I'm stage IV and had genetic testing done in order to have the report for my kids.  (Turns out, I have no "melanoma" genes, just some unfortunate luck, etc.)  If I wasn't stage IV, I probably would've deferred the testing to a later date given the rapid advances in that area.  Again, the primary motivation being having the info for my kids, not for myself.

                      • April 28, 2016 at 8:21 pm
                      Mat
                      Participant

                        I'm stage IV and had genetic testing done in order to have the report for my kids.  (Turns out, I have no "melanoma" genes, just some unfortunate luck, etc.)  If I wasn't stage IV, I probably would've deferred the testing to a later date given the rapid advances in that area.  Again, the primary motivation being having the info for my kids, not for myself.

                        • April 28, 2016 at 8:21 pm
                        Mat
                        Participant

                          I'm stage IV and had genetic testing done in order to have the report for my kids.  (Turns out, I have no "melanoma" genes, just some unfortunate luck, etc.)  If I wasn't stage IV, I probably would've deferred the testing to a later date given the rapid advances in that area.  Again, the primary motivation being having the info for my kids, not for myself.

                          • April 29, 2016 at 3:41 am
                          Charlie S
                          Participant

                            MIS?? What is that Mission Impossible?

                            State your case and say what you mean.

                            Fortunately for you I could decipher what you mean.

                            One melanoma insitu………………..which is NOT melanoma.

                            A one a?  Show me the pathology.

                            I get your concern, but this is a non-question, given your history.

                            Your derm has given you bad advice.

                            Worry all you want; no medical test is going  to alleviate that for you.

                             

                            • April 29, 2016 at 3:41 am
                            Charlie S
                            Participant

                              MIS?? What is that Mission Impossible?

                              State your case and say what you mean.

                              Fortunately for you I could decipher what you mean.

                              One melanoma insitu………………..which is NOT melanoma.

                              A one a?  Show me the pathology.

                              I get your concern, but this is a non-question, given your history.

                              Your derm has given you bad advice.

                              Worry all you want; no medical test is going  to alleviate that for you.

                               

                              • April 29, 2016 at 3:41 am
                              Charlie S
                              Participant

                                MIS?? What is that Mission Impossible?

                                State your case and say what you mean.

                                Fortunately for you I could decipher what you mean.

                                One melanoma insitu………………..which is NOT melanoma.

                                A one a?  Show me the pathology.

                                I get your concern, but this is a non-question, given your history.

                                Your derm has given you bad advice.

                                Worry all you want; no medical test is going  to alleviate that for you.

                                 

                                  • April 29, 2016 at 9:11 pm
                                  jenny22
                                  Participant

                                    WOW, awfully strong response!!!!!!

                                    ….and melanoma in-situ, IS still melanoma

                                    • April 29, 2016 at 9:11 pm
                                    jenny22
                                    Participant

                                      WOW, awfully strong response!!!!!!

                                      ….and melanoma in-situ, IS still melanoma

                                      • April 29, 2016 at 9:11 pm
                                      jenny22
                                      Participant

                                        WOW, awfully strong response!!!!!!

                                        ….and melanoma in-situ, IS still melanoma

                                        • April 29, 2016 at 11:02 pm
                                        m355
                                        Participant

                                          this is my 3rd melanoma. given it is my 3rd, the derm, pathologist and oncologist said it is something to consider.  and here is the most recent report:

                                          Here is lab report:

                                          A) Skin, right upper back, punch biopsy: Severely
                                          atypical compound melanocytic proliferation, see
                                          Comment.

                                          COMMENT:
                                          This is a worrisome lesion, with epidermal atypia
                                          (pagetoid extension, confluent growth) consistent with
                                          melanoma in situ and a dermal component that also
                                          demonstrates atypia with areas of morphologically
                                          similar cells to the epidermal component, but also some
                                           reassuring features (dispersion with increasing dermal
                                           depth, absence of mitoses). These findings engender a
                                          differential diagnosis that could reasonably include
                                          melanoma in situ evolving within a dysplastic nevus or
                                          a superfically invasive melanoma. Given this
                                          differential, it would be reasonable to treat this
                                          lesion as if it represents a malignant melanoma with
                                          the following prognostic factors: Breslow depth 0.32mm,
                                           Clark's level II, 0 mitoses/mm2, no ulceration.
                                           

                                          MICROSCOPIC DESCRIPTION:
                                          A) Sections show a punch biopsy with a compound
                                          melanocytic proliferation. The junctional component
                                          shows crowding, with fusion between adjacent rete and
                                          horizontal nests. Areas of upward extension of single
                                          melanocytes and nests are seen, and highlighted by
                                          Melan-A. Intraepidermal melanocytes show cytologic
                                          atypia, with nuclear enlargement and abundant
                                          cytoplasm. A patchy lymphohistiocytic inflammatory
                                          infiltrate is present. The lesion is free of the punch
                                          biopsy margin. Additional step sections are examined.
                                           

                                          • April 29, 2016 at 11:02 pm
                                          m355
                                          Participant

                                            this is my 3rd melanoma. given it is my 3rd, the derm, pathologist and oncologist said it is something to consider.  and here is the most recent report:

                                            Here is lab report:

                                            A) Skin, right upper back, punch biopsy: Severely
                                            atypical compound melanocytic proliferation, see
                                            Comment.

                                            COMMENT:
                                            This is a worrisome lesion, with epidermal atypia
                                            (pagetoid extension, confluent growth) consistent with
                                            melanoma in situ and a dermal component that also
                                            demonstrates atypia with areas of morphologically
                                            similar cells to the epidermal component, but also some
                                             reassuring features (dispersion with increasing dermal
                                             depth, absence of mitoses). These findings engender a
                                            differential diagnosis that could reasonably include
                                            melanoma in situ evolving within a dysplastic nevus or
                                            a superfically invasive melanoma. Given this
                                            differential, it would be reasonable to treat this
                                            lesion as if it represents a malignant melanoma with
                                            the following prognostic factors: Breslow depth 0.32mm,
                                             Clark's level II, 0 mitoses/mm2, no ulceration.
                                             

                                            MICROSCOPIC DESCRIPTION:
                                            A) Sections show a punch biopsy with a compound
                                            melanocytic proliferation. The junctional component
                                            shows crowding, with fusion between adjacent rete and
                                            horizontal nests. Areas of upward extension of single
                                            melanocytes and nests are seen, and highlighted by
                                            Melan-A. Intraepidermal melanocytes show cytologic
                                            atypia, with nuclear enlargement and abundant
                                            cytoplasm. A patchy lymphohistiocytic inflammatory
                                            infiltrate is present. The lesion is free of the punch
                                            biopsy margin. Additional step sections are examined.
                                             

                                            • April 29, 2016 at 11:02 pm
                                            m355
                                            Participant

                                              this is my 3rd melanoma. given it is my 3rd, the derm, pathologist and oncologist said it is something to consider.  and here is the most recent report:

                                              Here is lab report:

                                              A) Skin, right upper back, punch biopsy: Severely
                                              atypical compound melanocytic proliferation, see
                                              Comment.

                                              COMMENT:
                                              This is a worrisome lesion, with epidermal atypia
                                              (pagetoid extension, confluent growth) consistent with
                                              melanoma in situ and a dermal component that also
                                              demonstrates atypia with areas of morphologically
                                              similar cells to the epidermal component, but also some
                                               reassuring features (dispersion with increasing dermal
                                               depth, absence of mitoses). These findings engender a
                                              differential diagnosis that could reasonably include
                                              melanoma in situ evolving within a dysplastic nevus or
                                              a superfically invasive melanoma. Given this
                                              differential, it would be reasonable to treat this
                                              lesion as if it represents a malignant melanoma with
                                              the following prognostic factors: Breslow depth 0.32mm,
                                               Clark's level II, 0 mitoses/mm2, no ulceration.
                                               

                                              MICROSCOPIC DESCRIPTION:
                                              A) Sections show a punch biopsy with a compound
                                              melanocytic proliferation. The junctional component
                                              shows crowding, with fusion between adjacent rete and
                                              horizontal nests. Areas of upward extension of single
                                              melanocytes and nests are seen, and highlighted by
                                              Melan-A. Intraepidermal melanocytes show cytologic
                                              atypia, with nuclear enlargement and abundant
                                              cytoplasm. A patchy lymphohistiocytic inflammatory
                                              infiltrate is present. The lesion is free of the punch
                                              biopsy margin. Additional step sections are examined.
                                               

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