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Biopsy Results. Melanoma.

Forums Cutaneous Melanoma Community Biopsy Results. Melanoma.

  • Post
    Yvonne.D
    Participant
      I have just been diagnosed with Melanoma and looking for some help with my report. I need to stay positive, strong and informed for my 5 month old, 6 1\2 year old and my husband and hoping someone can help. If anyone can help me explain my report for me. Also if anyone has been through what is close to my diagnosis I would greatly appreciate your comments or experiences and what treatments you have had. Everyones cases seem to be different in some way so even any thoughts would be wonderful.

      Here goes. Biopsy Report.

      Surgicial incision with 1 cm MA of skin. Left thigh. Superficial Spreading Malignant Melanoma. Level 2 invasion, vertical height 0.47- No ulceration. Mitotic index is one mitosis per 1 mm squared.

      On November 18th I had an appointment with the Dermatologist who looked at my mole. She then made an appointment on the 27th to have a biopsy. On the 27th she did a shave biopsy. Apparently she was ruling out 3 possibilities. She said make an appointment to come back in for the results which was going to be for tomorrow however my family doctor called to tell me last thursday to tell me that it was Melanoma. I called my dermatologist right after that tryin to get in earlier to see them for the results which was now really just for the specifics on how bad it was as my family doctor was only able to tell me it was superficial. So I was a mess that day thinking my children and husband were going to be without me very soon as I have only ever heard that melanoma is a death sentence and was not educated at all about melanoma. I don’t think I have read as much as I did over the past 5 days about other peoples stories and information about it. Thank you to everyone who posts. I did get in yesterday for the results because they had a cancellation. I have an appointment on December 31st to have a surgery. I have to call the nurse back tomorrow just to discuss a few more details about the report as I was just listening as she went over specifics and didn’t know the right questions to ask or more so couldn’t. Now I have a grip of myself enough to talk and be the best informed and educated patient I can be hopefully with a little help for you guys.

      I do suspect that I have more on my body as well. The one they diagnosed was brushed aside saying it looked fine by my family doctor as well as by my OB after I asked what they thought about it. I cannot say enough to other people to go with your gut and get that referral if you suspect it is not normal. They are both wonderful doctors and could not say a bad thing about them, after all they are not a dermatologist.
      I have an appointment in the New Year to do a full body with my dermatologist.

      I am in Southern Ontario and have a few cancer hospitals from a 30 min drive as far as a 1hr 30min drive so I am feeling positive that if need be I can get the care I need very close.

      I was going through web pages trying to figure out my diagnosis and think I may be a T2A as of right now please correct me if wrong. Once I have my surgery that may change as the nurse said they didnt get it all when hey shaved it and could be bigger.

      Your thoughts, suggestions, anything would be greatly appreciated.

      Yvonne.

    Viewing 2 reply threads
    • Replies
        Janner
        Participant

          This is a stage IB lesion. When you say they didn't get it all in the biopsy, the key is which margins were involved.  Was the deep margin involved or were the peripheral margins involved?

          Most non-dermatologists do not really have a clue when it comes to diagnosing melanoma.  I remember seeing a study years back that said 73% of primary care doctors misdiagnosed melanoma.  The key is to watch for the "ugly duckling".  Has it changed?  Was it itching?  Those are the thing I look for.  Please understand that less than 10% of the melanoma population EVER have more than one melanoma primary.  So your statement that you have more is probably not the case.

          Your prognosis is good.  It's considered thin and low risk.  I've had two stage IB lesions deeper than yours (and a stage 0 lesion) – the first of which was in 1992.  I'm still stage IB and still here.  Good luck on your surgery.  Watch your moles for CHANGE!  And try not to worry too much.

          Best wishes,

          Janner

            Yvonne.D
            Participant
              Thank you for your reply Janner!

              I asked the nurse that went over my results and she said they didn’t get all. That based on what they took in the shave biospy it is deeper however I didn’t get clarification of which one for the 2 you are talking about. I asked just about the depth and when they shaved it was it through the whole piece and she said yes. I didn’t really know what I was talking about and not sure if she understood what I was trying to say. She said that it was deeper then the 1mm they removed and will find out how deep after they do the surgery and get it all. I wish I knew the right questions to ask then but I guess there’s a little more to the story and the coming weeks will shed some more light on this once the complete pathology report comes back. At least I think its called that.

              The unfortunate thing is that I have had freckles all over my body since I was a child and accumulated quite a few more as the years progressed and I heard that during pregnancy they tend to get darker (its nothing…) but none of my freckles I have had for years got darker only the most recent ones on my body. The one they biopsied just seemed to appear one day but can’t say I stare at my behind in the mirror. However when I happened to be checking myself out just to see just how big I was getting after getting out of the shower in the full length mirror and happened to notice this giant, what looked like a really dark mole and instantly felt uneasy feeling, but brushed it off and said I will see what happens with it. Meanwhile 9 months later if not more. It had never bothered me or itched. The reason I think I have a few more is because I have 2 that are the same color on my stomach that were never there before has the same coloring as the one they removed. They are smaller then a pencil eraser tip but are getting larger. Guess this is where the full body check will be good in the new year and keep an eye on them. I do like the facts you bring up Janner. It is helpful and makes me feel better as I didn’t know that fact. I am sure every spot I see I will think its that. Pictures really do come in handy to keep an eye on things. I will make sure to keep a good record of them all.

              It helps to know that you have been through the same and are doing fine and well. That really was the hardest thing the first few days, was thinking the light at the end of the tunnel was near. Well here’s to many more sunrises and sunsets in a shaded area wearing a nice big hat, with the smell of sunscreen as my new perfume!

              Thanks for your kind words and wonderful tips!

              Janner
              Participant

                For future biopsies, I might suggest asking for a "punch" instead of a shave.  When you shave through a lesion, you lose important staging information.  It will be hard for them to know the actual depth – you can't just add the original biopsy depth to the depth taken later because the samples don't line up.  Punch biopsies are full skin thickness biopsies.  Doctors like shaves because they are easy and require no stitches, but I won't have shave biopsies for the very reason I mentioned above.  (Also because I think they hurt more while healing). 

                Is your doc a melanoma specialist?  Also, I'm not sure the Canadian protocol, but I might be asking for a SNB IF your deep margin isn't clear.  Basically, that means you don't know the actual depth of the lesion and it might be worth checking your lymph nodes.  This HAS to be done at the time of the WLE or prior. It's something I would discuss with your doc if possible.  If it is only the side margins that aren't clear, then the depth stands at 0.47mm and you probably don't need the SNB.  If you can get a copy of your pathology report, that might help.

                Janner

                Yvonne.D
                Participant
                  Thanks again for the reply Janner!

                  I had the WLE done on the 31st. The Surgeon that did it said that given my path report a SNB would not be required. She seemed to know what she was talking about. I hope it doesn’t come back to kick me. I have a appointment with her for the results on Feb 5th. She recommends punch biopsys and not shaves just as you recommended. Apparently my derm does not do punches, the surgeon said. I was mislead by the nurse that gave me my path report results. She said that they were ruling out 3 possibilities and that is why they did the shave. Guess it was that or nothing from them. My full body check is the 23rd and I am going to have it done but going to ask my new family doctor(We moved in Aug and was travelling to our old dr) who said he has a few dermatologists if I would like to talk to in our town or in Toronto that he could refer me to. I am going to do that. I don’t feel comfortable with this Dermatologist or their staff. The Surgeon even said in choice words it would be better. I want a good Derm going forward. One that actually specializes in melanoma like you said.

                  I am anxious for the pathology report. I want to get a copy of both my reports. Could you tell me what wording that I am looking for? Clear Margins? She will probably go into detail but I don’t want to go in blind again not knowing the terminology or questions I should ask. I saw questions that I could ask when googling but are there any that you recommend that I should be asking?

                  Your right on the shave biopsy it does hurt. My WLE hurts but I can understand that. They took a chunk out! That and the bruising which is bigger then my fist closed. Punches are the way of the future. However hope none will have to be done.

                  Yvonne.D
                  Participant
                    Thanks again for the reply Janner!

                    I had the WLE done on the 31st. The Surgeon that did it said that given my path report a SNB would not be required. She seemed to know what she was talking about. I hope it doesn’t come back to kick me. I have a appointment with her for the results on Feb 5th. She recommends punch biopsys and not shaves just as you recommended. Apparently my derm does not do punches, the surgeon said. I was mislead by the nurse that gave me my path report results. She said that they were ruling out 3 possibilities and that is why they did the shave. Guess it was that or nothing from them. My full body check is the 23rd and I am going to have it done but going to ask my new family doctor(We moved in Aug and was travelling to our old dr) who said he has a few dermatologists if I would like to talk to in our town or in Toronto that he could refer me to. I am going to do that. I don’t feel comfortable with this Dermatologist or their staff. The Surgeon even said in choice words it would be better. I want a good Derm going forward. One that actually specializes in melanoma like you said.

                    I am anxious for the pathology report. I want to get a copy of both my reports. Could you tell me what wording that I am looking for? Clear Margins? She will probably go into detail but I don’t want to go in blind again not knowing the terminology or questions I should ask. I saw questions that I could ask when googling but are there any that you recommend that I should be asking?

                    Your right on the shave biopsy it does hurt. My WLE hurts but I can understand that. They took a chunk out! That and the bruising which is bigger then my fist closed. Punches are the way of the future. However hope none will have to be done.

                    Yvonne.D
                    Participant
                      Thanks again for the reply Janner!

                      I had the WLE done on the 31st. The Surgeon that did it said that given my path report a SNB would not be required. She seemed to know what she was talking about. I hope it doesn’t come back to kick me. I have a appointment with her for the results on Feb 5th. She recommends punch biopsys and not shaves just as you recommended. Apparently my derm does not do punches, the surgeon said. I was mislead by the nurse that gave me my path report results. She said that they were ruling out 3 possibilities and that is why they did the shave. Guess it was that or nothing from them. My full body check is the 23rd and I am going to have it done but going to ask my new family doctor(We moved in Aug and was travelling to our old dr) who said he has a few dermatologists if I would like to talk to in our town or in Toronto that he could refer me to. I am going to do that. I don’t feel comfortable with this Dermatologist or their staff. The Surgeon even said in choice words it would be better. I want a good Derm going forward. One that actually specializes in melanoma like you said.

                      I am anxious for the pathology report. I want to get a copy of both my reports. Could you tell me what wording that I am looking for? Clear Margins? She will probably go into detail but I don’t want to go in blind again not knowing the terminology or questions I should ask. I saw questions that I could ask when googling but are there any that you recommend that I should be asking?

                      Your right on the shave biopsy it does hurt. My WLE hurts but I can understand that. They took a chunk out! That and the bruising which is bigger then my fist closed. Punches are the way of the future. However hope none will have to be done.

                      Janner
                      Participant

                        For future biopsies, I might suggest asking for a "punch" instead of a shave.  When you shave through a lesion, you lose important staging information.  It will be hard for them to know the actual depth – you can't just add the original biopsy depth to the depth taken later because the samples don't line up.  Punch biopsies are full skin thickness biopsies.  Doctors like shaves because they are easy and require no stitches, but I won't have shave biopsies for the very reason I mentioned above.  (Also because I think they hurt more while healing). 

                        Is your doc a melanoma specialist?  Also, I'm not sure the Canadian protocol, but I might be asking for a SNB IF your deep margin isn't clear.  Basically, that means you don't know the actual depth of the lesion and it might be worth checking your lymph nodes.  This HAS to be done at the time of the WLE or prior. It's something I would discuss with your doc if possible.  If it is only the side margins that aren't clear, then the depth stands at 0.47mm and you probably don't need the SNB.  If you can get a copy of your pathology report, that might help.

                        Janner

                        Janner
                        Participant

                          For future biopsies, I might suggest asking for a "punch" instead of a shave.  When you shave through a lesion, you lose important staging information.  It will be hard for them to know the actual depth – you can't just add the original biopsy depth to the depth taken later because the samples don't line up.  Punch biopsies are full skin thickness biopsies.  Doctors like shaves because they are easy and require no stitches, but I won't have shave biopsies for the very reason I mentioned above.  (Also because I think they hurt more while healing). 

                          Is your doc a melanoma specialist?  Also, I'm not sure the Canadian protocol, but I might be asking for a SNB IF your deep margin isn't clear.  Basically, that means you don't know the actual depth of the lesion and it might be worth checking your lymph nodes.  This HAS to be done at the time of the WLE or prior. It's something I would discuss with your doc if possible.  If it is only the side margins that aren't clear, then the depth stands at 0.47mm and you probably don't need the SNB.  If you can get a copy of your pathology report, that might help.

                          Janner

                          Yvonne.D
                          Participant
                            Thank you for your reply Janner!

                            I asked the nurse that went over my results and she said they didn’t get all. That based on what they took in the shave biospy it is deeper however I didn’t get clarification of which one for the 2 you are talking about. I asked just about the depth and when they shaved it was it through the whole piece and she said yes. I didn’t really know what I was talking about and not sure if she understood what I was trying to say. She said that it was deeper then the 1mm they removed and will find out how deep after they do the surgery and get it all. I wish I knew the right questions to ask then but I guess there’s a little more to the story and the coming weeks will shed some more light on this once the complete pathology report comes back. At least I think its called that.

                            The unfortunate thing is that I have had freckles all over my body since I was a child and accumulated quite a few more as the years progressed and I heard that during pregnancy they tend to get darker (its nothing…) but none of my freckles I have had for years got darker only the most recent ones on my body. The one they biopsied just seemed to appear one day but can’t say I stare at my behind in the mirror. However when I happened to be checking myself out just to see just how big I was getting after getting out of the shower in the full length mirror and happened to notice this giant, what looked like a really dark mole and instantly felt uneasy feeling, but brushed it off and said I will see what happens with it. Meanwhile 9 months later if not more. It had never bothered me or itched. The reason I think I have a few more is because I have 2 that are the same color on my stomach that were never there before has the same coloring as the one they removed. They are smaller then a pencil eraser tip but are getting larger. Guess this is where the full body check will be good in the new year and keep an eye on them. I do like the facts you bring up Janner. It is helpful and makes me feel better as I didn’t know that fact. I am sure every spot I see I will think its that. Pictures really do come in handy to keep an eye on things. I will make sure to keep a good record of them all.

                            It helps to know that you have been through the same and are doing fine and well. That really was the hardest thing the first few days, was thinking the light at the end of the tunnel was near. Well here’s to many more sunrises and sunsets in a shaded area wearing a nice big hat, with the smell of sunscreen as my new perfume!

                            Thanks for your kind words and wonderful tips!

                            Yvonne.D
                            Participant
                              Thank you for your reply Janner!

                              I asked the nurse that went over my results and she said they didn’t get all. That based on what they took in the shave biospy it is deeper however I didn’t get clarification of which one for the 2 you are talking about. I asked just about the depth and when they shaved it was it through the whole piece and she said yes. I didn’t really know what I was talking about and not sure if she understood what I was trying to say. She said that it was deeper then the 1mm they removed and will find out how deep after they do the surgery and get it all. I wish I knew the right questions to ask then but I guess there’s a little more to the story and the coming weeks will shed some more light on this once the complete pathology report comes back. At least I think its called that.

                              The unfortunate thing is that I have had freckles all over my body since I was a child and accumulated quite a few more as the years progressed and I heard that during pregnancy they tend to get darker (its nothing…) but none of my freckles I have had for years got darker only the most recent ones on my body. The one they biopsied just seemed to appear one day but can’t say I stare at my behind in the mirror. However when I happened to be checking myself out just to see just how big I was getting after getting out of the shower in the full length mirror and happened to notice this giant, what looked like a really dark mole and instantly felt uneasy feeling, but brushed it off and said I will see what happens with it. Meanwhile 9 months later if not more. It had never bothered me or itched. The reason I think I have a few more is because I have 2 that are the same color on my stomach that were never there before has the same coloring as the one they removed. They are smaller then a pencil eraser tip but are getting larger. Guess this is where the full body check will be good in the new year and keep an eye on them. I do like the facts you bring up Janner. It is helpful and makes me feel better as I didn’t know that fact. I am sure every spot I see I will think its that. Pictures really do come in handy to keep an eye on things. I will make sure to keep a good record of them all.

                              It helps to know that you have been through the same and are doing fine and well. That really was the hardest thing the first few days, was thinking the light at the end of the tunnel was near. Well here’s to many more sunrises and sunsets in a shaded area wearing a nice big hat, with the smell of sunscreen as my new perfume!

                              Thanks for your kind words and wonderful tips!

                            Janner
                            Participant

                              This is a stage IB lesion. When you say they didn't get it all in the biopsy, the key is which margins were involved.  Was the deep margin involved or were the peripheral margins involved?

                              Most non-dermatologists do not really have a clue when it comes to diagnosing melanoma.  I remember seeing a study years back that said 73% of primary care doctors misdiagnosed melanoma.  The key is to watch for the "ugly duckling".  Has it changed?  Was it itching?  Those are the thing I look for.  Please understand that less than 10% of the melanoma population EVER have more than one melanoma primary.  So your statement that you have more is probably not the case.

                              Your prognosis is good.  It's considered thin and low risk.  I've had two stage IB lesions deeper than yours (and a stage 0 lesion) – the first of which was in 1992.  I'm still stage IB and still here.  Good luck on your surgery.  Watch your moles for CHANGE!  And try not to worry too much.

                              Best wishes,

                              Janner

                              Janner
                              Participant

                                This is a stage IB lesion. When you say they didn't get it all in the biopsy, the key is which margins were involved.  Was the deep margin involved or were the peripheral margins involved?

                                Most non-dermatologists do not really have a clue when it comes to diagnosing melanoma.  I remember seeing a study years back that said 73% of primary care doctors misdiagnosed melanoma.  The key is to watch for the "ugly duckling".  Has it changed?  Was it itching?  Those are the thing I look for.  Please understand that less than 10% of the melanoma population EVER have more than one melanoma primary.  So your statement that you have more is probably not the case.

                                Your prognosis is good.  It's considered thin and low risk.  I've had two stage IB lesions deeper than yours (and a stage 0 lesion) – the first of which was in 1992.  I'm still stage IB and still here.  Good luck on your surgery.  Watch your moles for CHANGE!  And try not to worry too much.

                                Best wishes,

                                Janner

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