Janner and all Stage 1 B’s can you help me?

One thing to remember…while I had mine removed  along with every mole on my body 4 years later it showed up in the same spot on my neck . It was removed again along with 5 SLN…they said all clear nothing to worry about…I have never had another spot on my skin………it showed up 9 years later in a lymph node by my heart and it was 6.8 cent at the widest…and so I was stage 4…while going to a derm doc is important…melanoma doesn't always show up on the skin…it just takes one micro cell to pass through sight unsee…to kill a person..

One thing to remember…while I had mine removed  along with every mole on my body 4 years later it showed up in the same spot on my neck . It was removed again along with 5 SLN…they said all clear nothing to worry about…I have never had another spot on my skin………it showed up 9 years later in a lymph node by my heart and it was 6.8 cent at the widest…and so I was stage 4…while going to a derm doc is important…melanoma doesn't always show up on the skin…it just takes one micro cell to pass through sight unsee…to kill a person..

One thing to remember…while I had mine removed  along with every mole on my body 4 years later it showed up in the same spot on my neck . It was removed again along with 5 SLN…they said all clear nothing to worry about…I have never had another spot on my skin………it showed up 9 years later in a lymph node by my heart and it was 6.8 cent at the widest…and so I was stage 4…while going to a derm doc is important…melanoma doesn't always show up on the skin…it just takes one micro cell to pass through sight unsee…to kill a person..

Actually shave biopsies have been shown in studies to be fine for melanoma pathology to be correct, it is punch biopsies that were shown to mess up the margins.  Here is the article about it:  http://www.sciencedaily.com/releases/2011/05/110523124400.htm 

The depth of your lesion is the number one indicator of how you will do.  There is an article that now states mitosis is actually not a valid measure:  http://markahurt.com/files/documents/20101605hurt-Art-5-mitoses-in-melanoma.pdf 

The depth of your lesion is the number one indicator of how you will do.  There is an article that now states mitosis is actually not a valid measure:  http://markahurt.com/files/documents/20101605hurt-Art-5-mitoses-in-melanoma.pdf 

The depth of your lesion is the number one indicator of how you will do.  There is an article that now states mitosis is actually not a valid measure:  http://markahurt.com/files/documents/20101605hurt-Art-5-mitoses-in-melanoma.pdf 

But, then others in the same article say, "In my opinion, dermal mitosis in thin melanomas reflects tumorigenic phase and therefore is of great concern." in the same article. . .

But, then others in the same article say, "In my opinion, dermal mitosis in thin melanomas reflects tumorigenic phase and therefore is of great concern." in the same article. . .

But, then others in the same article say, "In my opinion, dermal mitosis in thin melanomas reflects tumorigenic phase and therefore is of great concern." in the same article. . .

I haven't read the article, but know both methods are fine in terms of generally being able to diagnose melanoma.  Both are widely used for biopsy of pigmented lesions.  Shaves, however, can compromise staging.  That's often the case.  Shave biopsies are easy for docs, quick, require no stitches.  That's why they're often done.  But when they cut through a lesion, you lose the ability to accurately stage someone.  So while I will have punch biopsies, I will never again have a shave biopsy for suspected melanoma.  As depth is the most important factor and punch biopsies rarely compromise depth, that makes the most sense to me.

I haven't read the article, but know both methods are fine in terms of generally being able to diagnose melanoma.  Both are widely used for biopsy of pigmented lesions.  Shaves, however, can compromise staging.  That's often the case.  Shave biopsies are easy for docs, quick, require no stitches.  That's why they're often done.  But when they cut through a lesion, you lose the ability to accurately stage someone.  So while I will have punch biopsies, I will never again have a shave biopsy for suspected melanoma.  As depth is the most important factor and punch biopsies rarely compromise depth, that makes the most sense to me.

I haven't read the article, but know both methods are fine in terms of generally being able to diagnose melanoma.  Both are widely used for biopsy of pigmented lesions.  Shaves, however, can compromise staging.  That's often the case.  Shave biopsies are easy for docs, quick, require no stitches.  That's why they're often done.  But when they cut through a lesion, you lose the ability to accurately stage someone.  So while I will have punch biopsies, I will never again have a shave biopsy for suspected melanoma.  As depth is the most important factor and punch biopsies rarely compromise depth, that makes the most sense to me.

Actually shave biopsies have been shown in studies to be fine for melanoma pathology to be correct, it is punch biopsies that were shown to mess up the margins.  Here is the article about it:  http://www.sciencedaily.com/releases/2011/05/110523124400.htm 

Actually shave biopsies have been shown in studies to be fine for melanoma pathology to be correct, it is punch biopsies that were shown to mess up the margins.  Here is the article about it:  http://www.sciencedaily.com/releases/2011/05/110523124400.htm 

Here's the deal.  No analysis of your pathology reports is going to give you the answer you want.  You cannot deduce whether or not you will have a recurrence or what your particular odds are given your exact factors.  There will always be percentages of high risk individuals who never do, and low risk individuals that do recur.  The factors that have shown to be the most predictive are the ones currently used in staging.  Certainly other factors may be introduced in the future as anaylsis shows other significant factors, but the staging guidelines are the best we have at the moment for predicting your prognosis.  The analysis was done on a large group of people giving you the best information you can have.  Beware reading about studies that only have small population numbers as results may not be the same when done over a large population.  Time will help, but no amount of research is going to answer your question for you.  It sucks, but it's the reality.

As for "what does it look like", it will look different.  Maybe pigmented, maybe a bump under the skin.  For the first year, your scar will be healing and you may have scar tissues, stitches or just plain healing that causes changes in the scar.  Have any other incisions you watched heal?  You're looking for something that doesn't seem to be a normal part of healing.  If you see something concerning, ask your doctor.  In addition, ask your doctor how to palpate your lymph basin (same as the SNB basin).  You should also pay attention to that area and be looking for swollen/hard lymph nodes.  Be aware that while you are still healing or if you have trauma, lymph nodes will swell and it is most likely unrelated to melanoma.

I wish I could be more help, but you're not going to find the help you want… an answer to your future.  The more research you do, the more you will know about melanoma – but not how it will apply to you.  Believe me, I know this to be true.  Excessive research causes excessive anxiety (speaking from experience).  Hang in there,

Janner

Here's the deal.  No analysis of your pathology reports is going to give you the answer you want.  You cannot deduce whether or not you will have a recurrence or what your particular odds are given your exact factors.  There will always be percentages of high risk individuals who never do, and low risk individuals that do recur.  The factors that have shown to be the most predictive are the ones currently used in staging.  Certainly other factors may be introduced in the future as anaylsis shows other significant factors, but the staging guidelines are the best we have at the moment for predicting your prognosis.  The analysis was done on a large group of people giving you the best information you can have.  Beware reading about studies that only have small population numbers as results may not be the same when done over a large population.  Time will help, but no amount of research is going to answer your question for you.  It sucks, but it's the reality.

As for "what does it look like", it will look different.  Maybe pigmented, maybe a bump under the skin.  For the first year, your scar will be healing and you may have scar tissues, stitches or just plain healing that causes changes in the scar.  Have any other incisions you watched heal?  You're looking for something that doesn't seem to be a normal part of healing.  If you see something concerning, ask your doctor.  In addition, ask your doctor how to palpate your lymph basin (same as the SNB basin).  You should also pay attention to that area and be looking for swollen/hard lymph nodes.  Be aware that while you are still healing or if you have trauma, lymph nodes will swell and it is most likely unrelated to melanoma.

I wish I could be more help, but you're not going to find the help you want… an answer to your future.  The more research you do, the more you will know about melanoma – but not how it will apply to you.  Believe me, I know this to be true.  Excessive research causes excessive anxiety (speaking from experience).  Hang in there,

Janner

Here's the deal.  No analysis of your pathology reports is going to give you the answer you want.  You cannot deduce whether or not you will have a recurrence or what your particular odds are given your exact factors.  There will always be percentages of high risk individuals who never do, and low risk individuals that do recur.  The factors that have shown to be the most predictive are the ones currently used in staging.  Certainly other factors may be introduced in the future as anaylsis shows other significant factors, but the staging guidelines are the best we have at the moment for predicting your prognosis.  The analysis was done on a large group of people giving you the best information you can have.  Beware reading about studies that only have small population numbers as results may not be the same when done over a large population.  Time will help, but no amount of research is going to answer your question for you.  It sucks, but it's the reality.

As for "what does it look like", it will look different.  Maybe pigmented, maybe a bump under the skin.  For the first year, your scar will be healing and you may have scar tissues, stitches or just plain healing that causes changes in the scar.  Have any other incisions you watched heal?  You're looking for something that doesn't seem to be a normal part of healing.  If you see something concerning, ask your doctor.  In addition, ask your doctor how to palpate your lymph basin (same as the SNB basin).  You should also pay attention to that area and be looking for swollen/hard lymph nodes.  Be aware that while you are still healing or if you have trauma, lymph nodes will swell and it is most likely unrelated to melanoma.

I wish I could be more help, but you're not going to find the help you want… an answer to your future.  The more research you do, the more you will know about melanoma – but not how it will apply to you.  Believe me, I know this to be true.  Excessive research causes excessive anxiety (speaking from experience).  Hang in there,

Janner

Janner, you should read the article because the thinking on what is a better biopsy has changed.  You would prefer a punch, but in fact punch biopsy gives lousy incorrect margins. A deep shave is proven to give the best margins and depth when compared to a simple shave or punch.  The best biopsy however is always going to be the excisional which takes a stitch or two to close.  It often captures the whole melanoma.

Janner, you should read the article because the thinking on what is a better biopsy has changed.  You would prefer a punch, but in fact punch biopsy gives lousy incorrect margins. A deep shave is proven to give the best margins and depth when compared to a simple shave or punch.  The best biopsy however is always going to be the excisional which takes a stitch or two to close.  It often captures the whole melanoma.

Janner, you should read the article because the thinking on what is a better biopsy has changed.  You would prefer a punch, but in fact punch biopsy gives lousy incorrect margins. A deep shave is proven to give the best margins and depth when compared to a simple shave or punch.  The best biopsy however is always going to be the excisional which takes a stitch or two to close.  It often captures the whole melanoma.

I'm not impressed with the article that justifies shaves as ok.  Maybe you would be fine if your lesion was bisected but i would not even if the WLE was clear.  (I have had a deep shave for melanoma #3 and was lucky I had clear deep margins – I won't do this again).  This article justifies the shave saying the majority aren't upstaged because of the WLE.  But in my mind, you have lost valuable information as once the lesion is bisected, you will never again know the true depth.  And most shaves aren't "deep" shaves.  As for punches, if the lesion can't be contained in a punch, then an excisional biopsy or shave should be used.  Punches aren't great on wide lesions but they do have the advantage of getting several mm of depth.  There are guidelines for each type of biopsy and there are times when one type is better than another including partial biopsies and shaves.  I won't have another shave biopsy because I won't take a chance they bisect my lesion AND because they hurt like hell while healing and look worse afterwards.  I hate shave biopsies.  But for the most part, it's a moot point for me.  Because of my three primaries, my derm only does excisional biopsies on me.  I don't have a lot of biopsies because my moles basically appear to be stable at this time in my life.  But if I was having biopsies done frequently, I wouldn't choose a shave for the pain/scar and excisonal biopsies remove a lot of tissue and leave larger scars.  Punches, to me, are a good choice when a lesion fits inside a punch.  It's always a balancing act and discussing the biopsy type with a doc who is open to discussion (some will only do shaves and I don't see this as open minded) is definitely the best way to go.

This is my opinion only – yours may vary. 

I'm not impressed with the article that justifies shaves as ok.  Maybe you would be fine if your lesion was bisected but i would not even if the WLE was clear.  (I have had a deep shave for melanoma #3 and was lucky I had clear deep margins – I won't do this again).  This article justifies the shave saying the majority aren't upstaged because of the WLE.  But in my mind, you have lost valuable information as once the lesion is bisected, you will never again know the true depth.  And most shaves aren't "deep" shaves.  As for punches, if the lesion can't be contained in a punch, then an excisional biopsy or shave should be used.  Punches aren't great on wide lesions but they do have the advantage of getting several mm of depth.  There are guidelines for each type of biopsy and there are times when one type is better than another including partial biopsies and shaves.  I won't have another shave biopsy because I won't take a chance they bisect my lesion AND because they hurt like hell while healing and look worse afterwards.  I hate shave biopsies.  But for the most part, it's a moot point for me.  Because of my three primaries, my derm only does excisional biopsies on me.  I don't have a lot of biopsies because my moles basically appear to be stable at this time in my life.  But if I was having biopsies done frequently, I wouldn't choose a shave for the pain/scar and excisonal biopsies remove a lot of tissue and leave larger scars.  Punches, to me, are a good choice when a lesion fits inside a punch.  It's always a balancing act and discussing the biopsy type with a doc who is open to discussion (some will only do shaves and I don't see this as open minded) is definitely the best way to go.

This is my opinion only – yours may vary. 

I'm not impressed with the article that justifies shaves as ok.  Maybe you would be fine if your lesion was bisected but i would not even if the WLE was clear.  (I have had a deep shave for melanoma #3 and was lucky I had clear deep margins – I won't do this again).  This article justifies the shave saying the majority aren't upstaged because of the WLE.  But in my mind, you have lost valuable information as once the lesion is bisected, you will never again know the true depth.  And most shaves aren't "deep" shaves.  As for punches, if the lesion can't be contained in a punch, then an excisional biopsy or shave should be used.  Punches aren't great on wide lesions but they do have the advantage of getting several mm of depth.  There are guidelines for each type of biopsy and there are times when one type is better than another including partial biopsies and shaves.  I won't have another shave biopsy because I won't take a chance they bisect my lesion AND because they hurt like hell while healing and look worse afterwards.  I hate shave biopsies.  But for the most part, it's a moot point for me.  Because of my three primaries, my derm only does excisional biopsies on me.  I don't have a lot of biopsies because my moles basically appear to be stable at this time in my life.  But if I was having biopsies done frequently, I wouldn't choose a shave for the pain/scar and excisonal biopsies remove a lot of tissue and leave larger scars.  Punches, to me, are a good choice when a lesion fits inside a punch.  It's always a balancing act and discussing the biopsy type with a doc who is open to discussion (some will only do shaves and I don't see this as open minded) is definitely the best way to go.

This is my opinion only – yours may vary. 

To me. . it's just get the biopsy. .whatever the technique. . maybe your Dr would only do it if it were a simple shave. . otherwise might say "let's wait and watch".  to me, get the darn biopsy done. . however. . so at least if there is something it will be caught and dealt with. 

It's "at least 1.45mm" – not less.  It may have been just 1.45mm.  I'd just go with that and move ahead because there really is no other choice.  Hang in there!

It's "at least 1.45mm" – not less.  It may have been just 1.45mm.  I'd just go with that and move ahead because there really is no other choice.  Hang in there!

It's "at least 1.45mm" – not less.  It may have been just 1.45mm.  I'd just go with that and move ahead because there really is no other choice.  Hang in there!

To me. . it's just get the biopsy. .whatever the technique. . maybe your Dr would only do it if it were a simple shave. . otherwise might say "let's wait and watch".  to me, get the darn biopsy done. . however. . so at least if there is something it will be caught and dealt with. 

To me. . it's just get the biopsy. .whatever the technique. . maybe your Dr would only do it if it were a simple shave. . otherwise might say "let's wait and watch".  to me, get the darn biopsy done. . however. . so at least if there is something it will be caught and dealt with. 

Janner-help …diagnosed 1a. Easy to understand and read on one pathology report. Second path does not make sense.

my biggest fear is reoccurrence at this point to where

i have high anxiety and fear. 

Any advise….thanks 

Janner-help …diagnosed 1a. Easy to understand and read on one pathology report. Second path does not make sense.

my biggest fear is reoccurrence at this point to where

i have high anxiety and fear. 

Any advise….thanks 

Janner-help …diagnosed 1a. Easy to understand and read on one pathology report. Second path does not make sense.

my biggest fear is reoccurrence at this point to where

i have high anxiety and fear. 

Any advise….thanks