I need help for my cousin

Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

 

Josh

Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

 

Josh

Sorry…its 1mm in depth. My step mom had melanoma too…yes odd no familial ties but step mom. I believe she was .73mm in depth….they didn;t do one but she went for 2nd opinion and told her they should have and should have done it prior to surgery.

 

Josh

Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.

2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.

Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration

I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

However, please do post your biopsy report when you can. And give Denise a hug for me! 

Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook

Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook

Thank you for your response. I so wish I could hug Denise but we live too far from each other. We only communicate by Facebook

I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

However, please do post your biopsy report when you can. And give Denise a hug for me! 

I am very sorry to learn that you lost your daughter to melanoma and now have to face this frightening diagnosis yourself. That's so awful! However, please know that we are all here to support you and to share with you what we can of our knowledge and experience. Denise has been an amazing inspiration and helpful participant on this forum, so I'm sure she will be very helpful to you, too.

As Janner (our melanoma guru) said, to be most helpful to you we will need to see your whole pathology report. However, from what you have said so far it sounds as though you caught this lesion while it is still very small. You will want a wide local excision (WLE) to make certain it is all completely gone, but you will probably not need a sentinal node biopsy (SNB).  After that, I expect that you will have no further trouble with melanoma.

However, please do post your biopsy report when you can. And give Denise a hug for me! 

Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

Best wishes,

Janner

Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.

Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.

Thank you Janner. I am sure it will be ok. My daughter was diagnosed at 21 and had the snb. They said she was cured. However it spread through her blood stream and 3 years and 1 week after she passed away at 24. She was so courageous and had a smile that would brighten even the darkest room. She was an inspiration to all that had the pleasure of knowing her. I am sure you can understand my concerns with my own diagnosis.

Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?

Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?

Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.

Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.

Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

Three people in multiple generations is what they wanted for the Familial study I was in… or multiple primaries (>2).  The genetic defect I have (CDKN2A) is dominant and does not skip generations.  However, having the gene gives you a 76% lifetime risk of getting melanoma.  Not a sure thing, but the numbers are pretty daunting.  Only 2-4% of the melanoma population have this genetic defect.  There is another gene that covers  <1% of the population and others are thought to exist.  In addition, people with DNS may have multiple generations.  The info I was given said about 10% of melanomas were thought to have some genetic basis and 90% were sporadic.

Janner, I seem to recall you mentioning at one point that there is a research effort under way to study the genetic basis (if any) for melanoma. Is that correct? If so, having 3 people in one family afflicted by melanoma might be very helpful to that research effort. Can you comment?

Could it happen? Yes. Is it likely? No. Your daughters lesion was much higher risk than yours based on depth. The SNB is a diagnostic tool only and is not a guarantee of anything. I’m sorry the drainage path was never found with your daughter. Spreading through the blood supply is much rarer than through the lymph vessels. As for you, there is no treatment you can do other than pay attention to change. Moles or anything that seems out of the ordinary for you. Then move on. I know that is easier said than done given your history, but your risk is low and worrying only lets melanoma win again. Stage 1a is an exclusive club with an extremely high survival rate – definitely a different situation from your daughter. Hang in there and let me know if I can help.

http://jco.ascopubs.org/content/early/2012/03/06/JCO.2011.38.8561.full.pdf

http://jco.ascopubs.org/content/early/2012/03/06/JCO.2011.38.8561.full.pdf

http://jco.ascopubs.org/content/early/2012/03/06/JCO.2011.38.8561.full.pdf

Hello Janner. I had the wide incision on my 1A melanoma. I was told that that was all the treatment I needed. I pulled my daughters original path report and her melanoma was Breslow 1.48 Clark’s IV there was no ulceration. She had SNB. They couldn’t find the path of the dye, so they pulled about 30 nodes. The tested negative. They did not do any follow up treatment. It was not the protocol. However, her melanoma spread through her blood and when rediagnosed, she lived 11 months. I am scared/concerned that that could happen to me. Any thoughts?

Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

Best wishes,

Janner

Breslow 0.5mm and Clark Level II.  So the remaining question is mitosis.  Mitosis of <1 makes you stage IA.  Any other mitosis makes you stage IB.  The WLE is necessary, but you should discuss the SNB with your doc.  Stage 1A – probably not.  Stage IB – possibly.  Some sites do the SNB for every stage IB individual, others do it when the lesion is closer to 1mm.  Sometimes looking at the whole path report picture and seeing if it appears "low risk" or has some factors that make it a bit higher risk will determine the next step.  But regardless, I've been on this site for a very long time and 0.5mm/CL II is a low risk lesion.  I had a similar lesion removed 21 years ago (0.58mm/CL II/No SNB) and am still here to talk about it.  We can give you our best "non medical advice" if you can post your pathology report.  Sorry you have to join us here, but it sounds like things were truly caught early!

Best wishes,

Janner

Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration

Hello, I am Denise’s cousin. I believe the Breslow is .5 and Clark level is two. I do not believe there is ulceration

2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.

2mm deep may be stage 2, so a bit more serious. Stage 1a ends at 1mm and stage 1b ends at 2mm. But ulceration may bump up the stage. Mitosis is only used to differentiate between stage 1a and 1b. So getting the path report is key to know where she really stands.

Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.

Weird, but I didn't see the other replies before I answered.  Was the punch 2mm deep or the lesion?  Was it 1mm deep?  PATH REPORT!!!  If it was truly 1mm, then likely they would suggest doing the SNB.  But the total picture provided by the path report is really needed to make any real meaningful comments.  There are other factor to take into consideration.