› Forums › General Melanoma Community › Friend with a 0.2mm Melanoma
- This topic has 4 replies, 2 voices, and was last updated 12 years, 10 months ago by
Janner.
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- June 22, 2011 at 2:55 pm
As a newer member to the form I want to thank everyone for the abundance of great information that is available, It has been very helpful to me and my family.
I have a friend who was just diagnosed by her derm with a 0.2mm Melanoma on her upper back.
The derm is planning to remove the surrounding tissue, wide excision himself (she was told it could be about half the size of a football) . It is normal for derms to do this?
I know primary depth is a huge determining factor but my derm sent me straight to surgical Onc but my melanoma was greater that 1.0mm.
As a newer member to the form I want to thank everyone for the abundance of great information that is available, It has been very helpful to me and my family.
I have a friend who was just diagnosed by her derm with a 0.2mm Melanoma on her upper back.
The derm is planning to remove the surrounding tissue, wide excision himself (she was told it could be about half the size of a football) . It is normal for derms to do this?
I know primary depth is a huge determining factor but my derm sent me straight to surgical Onc but my melanoma was greater that 1.0mm.
Would it be best Surgical Onc for Wide excision and do a Node bx as well?
Thanks,
Allen
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- June 22, 2011 at 3:47 pm
I have a .30 mm Breslow melanoma, and my derm was qualified and able to perform the WLE or wide local excision right in his office as well.
Half the size of a football sounds a little large, as my scar was football or sideways v shaped (like this<>) It was shaped like two sideways v's with a quarter size round area in the center that was removed around the mole that was positive for melanoma. The sideways v area around the round quarter size area was made to assist with closing the skin. It did look like a small football before it was closed though. Overall, the scar is about 4 inches long. It is located on my upper center chest.
A SNB or sentinel node biopsy is not usually considered unless the melanoma Breslow depth is .75 mm if ulcerated and 1.0 mm if not. Your friend would not need a SNB at this juncture.
Congratulate your friend on catching this so early.
Michael
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- June 22, 2011 at 3:47 pm
I have a .30 mm Breslow melanoma, and my derm was qualified and able to perform the WLE or wide local excision right in his office as well.
Half the size of a football sounds a little large, as my scar was football or sideways v shaped (like this<>) It was shaped like two sideways v's with a quarter size round area in the center that was removed around the mole that was positive for melanoma. The sideways v area around the round quarter size area was made to assist with closing the skin. It did look like a small football before it was closed though. Overall, the scar is about 4 inches long. It is located on my upper center chest.
A SNB or sentinel node biopsy is not usually considered unless the melanoma Breslow depth is .75 mm if ulcerated and 1.0 mm if not. Your friend would not need a SNB at this juncture.
Congratulate your friend on catching this so early.
Michael
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- June 22, 2011 at 6:32 pm
A derm who does WLE regularly is certainly qualified to do them – no need to run to a surgical oncologist for an early stage lesion. I've had several WLE's done by a regular derm and they were just fine. The size of the scar depends on the location and how tight the skin is. Basically you take 1cm margins around the original lesion. However, you have to take an ellipse shaped excision to actually get the wound to close. In general, you need the width to be 3x the height of the wound for a lesion to close. So it could be as small as 6cm but it might be quite a bit longer depending on the anatomy. Some derms do WLE's, others automatically refer to a surgical oncologist. The important bit is just getting good margins which are verified via pathology.
Best wishes,
Janner
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- June 22, 2011 at 6:32 pm
A derm who does WLE regularly is certainly qualified to do them – no need to run to a surgical oncologist for an early stage lesion. I've had several WLE's done by a regular derm and they were just fine. The size of the scar depends on the location and how tight the skin is. Basically you take 1cm margins around the original lesion. However, you have to take an ellipse shaped excision to actually get the wound to close. In general, you need the width to be 3x the height of the wound for a lesion to close. So it could be as small as 6cm but it might be quite a bit longer depending on the anatomy. Some derms do WLE's, others automatically refer to a surgical oncologist. The important bit is just getting good margins which are verified via pathology.
Best wishes,
Janner
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