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Excise or Not excise that is the question!

Forums General Melanoma Community Excise or Not excise that is the question!

  • Post
    sarahandkawika
    Participant

    Okay, I blew it and let the stupid Derm do a scrape biopsy on my arm. I won't bore you with details. But this spot is a dyspastic nevus. and of course there are leftover cells in my skin. So, this derm says let him remove all the cells (nope!). MY derm specialist says it is all up to me whether I do or don't, everyone has varied opinion…So I would have the surgeon who did my graft remove the rest if I do…but the question is do I ?

    Any Opinions?

    Thanks

    Sarah, stage 3A NED 3 months

    Okay, I blew it and let the stupid Derm do a scrape biopsy on my arm. I won't bore you with details. But this spot is a dyspastic nevus. and of course there are leftover cells in my skin. So, this derm says let him remove all the cells (nope!). MY derm specialist says it is all up to me whether I do or don't, everyone has varied opinion…So I would have the surgeon who did my graft remove the rest if I do…but the question is do I ?

    Any Opinions?

    Thanks

    Sarah, stage 3A NED 3 months

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  • Replies
      dian in spokane
      Participant

      Since 1983, I have never turned down a reccommended wide excision. I am actually not sure what the upside of refusing an excision would be….beyond a smaller scar.

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      dian in spokane
      Participant

      Since 1983, I have never turned down a reccommended wide excision. I am actually not sure what the upside of refusing an excision would be….beyond a smaller scar.

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      MichaelFL
      Participant

      Hi Sarah,

      A dysplastic nevus (or what is called a atypical mole) is not yet melanoma. Most never do become melanoma. They are graded as mild, moderate or severe. Mild is usually watched for change, while moderate is considered for re-excision and severe is almost always re-excised. My derm re-excises both moderate and severe. He did re-excise my moderately atypical mole on my back and it was verified as having clear margins

      Sounds to me it is most likely mild or moderately atypical since he is giving you the option of deciding for yourself. It would be a good idea to to verify with the derm if it is mild, moderate or severe and thn make a decision from there. It would seem to me though that it would be better to have it re-excised and checked for clear margins for your own peace of mind.

      Also, a shave biopsy is not the best option if a mole is suspected to be melanoma. A punch or excisional should be performed instead as if on the off chance a mole is melanoma, there is always the chance a shave biopsy may transect the tumor and a correct Breslow depth may not be able to be properly obtained.

      Hope this helps some.

      Michael-stage 1b with a moderately atypical mole as well.

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      MichaelFL
      Participant

      Hi Sarah,

      A dysplastic nevus (or what is called a atypical mole) is not yet melanoma. Most never do become melanoma. They are graded as mild, moderate or severe. Mild is usually watched for change, while moderate is considered for re-excision and severe is almost always re-excised. My derm re-excises both moderate and severe. He did re-excise my moderately atypical mole on my back and it was verified as having clear margins

      Sounds to me it is most likely mild or moderately atypical since he is giving you the option of deciding for yourself. It would be a good idea to to verify with the derm if it is mild, moderate or severe and thn make a decision from there. It would seem to me though that it would be better to have it re-excised and checked for clear margins for your own peace of mind.

      Also, a shave biopsy is not the best option if a mole is suspected to be melanoma. A punch or excisional should be performed instead as if on the off chance a mole is melanoma, there is always the chance a shave biopsy may transect the tumor and a correct Breslow depth may not be able to be properly obtained.

      Hope this helps some.

      Michael-stage 1b with a moderately atypical mole as well.

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