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Excision and second biopsy
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Excision and second biopsy

› Forums › General Melanoma Community › Excision and second biopsy

  • Post
    • June 1, 2016 at 1:26 am
    msnow
    Participant

      Hi, hoping for some insight.  Seven years ago I had shave biopsy on a mole which changed shape during pregnancy.  I remember being told pathology was fine but I did not ask for written lab results…something I now always do.  I have a new dermatologist and mentioned this mole removed years ago.  She looked and noticed a bit of color but wasn't sure if it was part the remaining mole or scaring. Because I didn't have the original pathology results we decided to biopsy it again. Pathology came back as mild atypical, excision recommended.  My doctor is out of the office this week so the nurse called.

      Is excision really necessary for mild atypical?  Would scarring for multiple shave biopsy hide more advanced atypical cells in the current pathology results?  Should I be worried this mole was more serious seven years ago?  I thinking because there are no original slides to compare to the pathologist recommended complete excision.  Thx

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    • Replies
        • June 1, 2016 at 1:54 am
        Janner
        Participant

          Mildly atypical lesions – depending on who you talk to – may or may not need to be excised.  Many derms are fine with leaving mildly atypical lesions and only watching for pigment regrowth.  Others want any lesion with any atypical cells removed.

          So here's my take.  Any time you look at a lesion that has scar tissue, it will look "worse".   Scar tissue muddles things.  So you probably had a benign lesion 7 years ago or at worse, mildly atypical then.  But when you look at it now, it might look worse just because scar tissue exists.  My derm prefers to remove mildly atypical lesions completely but, I'm certain, if I really pushed him on it, he would just say we will watch for any pigment regrowth. 

          Honestly, I think you could go either way – it's what makes YOU comfortable.  But I don't think I would be worrying about the original lesion – extremely unlikely it was worse than mildly atypical like the current lesion.

            • June 13, 2016 at 8:07 am
            msnow
            Participant

              Thanks for the reply and sharing your knowledge.  After some thought and trying to obtain my original pathology to no avail I decided to go ahead with the excision with the plastic surgeon.  

              Just curious if you might know: can scar tissue from a previous shave biospy years ago hide more serious atypica or melanoma or would a pathologist be able to decipher this with my second shave biopsy?  Was talking with the nurse as my dermatologist is on vacation who stated.. We just have to wait and see what the excision pathology brings back.  I'm a bit confused as the latest biopsy states mild atypica.  She also said because the current dermatopathologist doesn't have the original report/sample they requested a total excision to make sure any atypica cells are removed.  Thanks again 

              • June 13, 2016 at 8:07 am
              msnow
              Participant

                Thanks for the reply and sharing your knowledge.  After some thought and trying to obtain my original pathology to no avail I decided to go ahead with the excision with the plastic surgeon.  

                Just curious if you might know: can scar tissue from a previous shave biospy years ago hide more serious atypica or melanoma or would a pathologist be able to decipher this with my second shave biopsy?  Was talking with the nurse as my dermatologist is on vacation who stated.. We just have to wait and see what the excision pathology brings back.  I'm a bit confused as the latest biopsy states mild atypica.  She also said because the current dermatopathologist doesn't have the original report/sample they requested a total excision to make sure any atypica cells are removed.  Thanks again 

                • June 13, 2016 at 8:07 am
                msnow
                Participant

                  Thanks for the reply and sharing your knowledge.  After some thought and trying to obtain my original pathology to no avail I decided to go ahead with the excision with the plastic surgeon.  

                  Just curious if you might know: can scar tissue from a previous shave biospy years ago hide more serious atypica or melanoma or would a pathologist be able to decipher this with my second shave biopsy?  Was talking with the nurse as my dermatologist is on vacation who stated.. We just have to wait and see what the excision pathology brings back.  I'm a bit confused as the latest biopsy states mild atypica.  She also said because the current dermatopathologist doesn't have the original report/sample they requested a total excision to make sure any atypica cells are removed.  Thanks again 

                • June 1, 2016 at 1:54 am
                Janner
                Participant

                  Mildly atypical lesions – depending on who you talk to – may or may not need to be excised.  Many derms are fine with leaving mildly atypical lesions and only watching for pigment regrowth.  Others want any lesion with any atypical cells removed.

                  So here's my take.  Any time you look at a lesion that has scar tissue, it will look "worse".   Scar tissue muddles things.  So you probably had a benign lesion 7 years ago or at worse, mildly atypical then.  But when you look at it now, it might look worse just because scar tissue exists.  My derm prefers to remove mildly atypical lesions completely but, I'm certain, if I really pushed him on it, he would just say we will watch for any pigment regrowth. 

                  Honestly, I think you could go either way – it's what makes YOU comfortable.  But I don't think I would be worrying about the original lesion – extremely unlikely it was worse than mildly atypical like the current lesion.

                  • June 1, 2016 at 1:54 am
                  Janner
                  Participant

                    Mildly atypical lesions – depending on who you talk to – may or may not need to be excised.  Many derms are fine with leaving mildly atypical lesions and only watching for pigment regrowth.  Others want any lesion with any atypical cells removed.

                    So here's my take.  Any time you look at a lesion that has scar tissue, it will look "worse".   Scar tissue muddles things.  So you probably had a benign lesion 7 years ago or at worse, mildly atypical then.  But when you look at it now, it might look worse just because scar tissue exists.  My derm prefers to remove mildly atypical lesions completely but, I'm certain, if I really pushed him on it, he would just say we will watch for any pigment regrowth. 

                    Honestly, I think you could go either way – it's what makes YOU comfortable.  But I don't think I would be worrying about the original lesion – extremely unlikely it was worse than mildly atypical like the current lesion.

                    • June 1, 2016 at 1:53 pm
                    Gene_S
                    Participant

                      You can always get your records from the old dermatologist and possibly copies of path report.

                      At least then you would know what exactly was said about the first one and then I would keep a personal file on dermatology reports, surgeries, pathologies.

                      • June 1, 2016 at 1:53 pm
                      Gene_S
                      Participant

                        You can always get your records from the old dermatologist and possibly copies of path report.

                        At least then you would know what exactly was said about the first one and then I would keep a personal file on dermatology reports, surgeries, pathologies.

                        • June 1, 2016 at 1:53 pm
                        Gene_S
                        Participant

                          You can always get your records from the old dermatologist and possibly copies of path report.

                          At least then you would know what exactly was said about the first one and then I would keep a personal file on dermatology reports, surgeries, pathologies.

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