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Might have to redo my WLE…opinions please.

Forums General Melanoma Community Might have to redo my WLE…opinions please.

  • Post
    lizyli2000
    Participant

    Hi there,

    Hi there,

    I haven't posted on the site for a couple of months now…just to give a quick run down… I was diagnosed in March 2010, with Stage 1 melanoma, 0.32mm, 0 mitosis, on my left forearm. I had my WLE done about two weeks after dianosis and all has been well so far. I have had my slides read by two different pathologists just to be on the safe side and they have both verified the Breslow Depth as well as the clear margins on my WLE. I recently moved to Boston and just went for my 3 month check up at Mass General in the Pigment Leson Center…this is where this question arised for the first time…

    The dr. that I saw was very suprised my the margins on my wle inison…he said the margins looked small and didn't fit the guidelines. He stated that all the reports came back as clear margins (again, they were read by 3 different pathologist) however he doesn't feel like the margins are big enough and is suggesting that I get my WLE redone. He stated that it was completely up to me…he would be shocked if there melnoma residue however, it could always happen. He requested to take a look at my post op report to see exactly how much skin was really excised because skin shrinks once it's removed. Well, guess what….it doesn't state the amount taken, just whatever is on the pathology report is what we have to go by, which are 3 x 1 x 0.7cm.

    I was finally starting to feel okay and starting to move on from thinking about melanoma all day. I really appreciate any feedback. Thanks so much.

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      patobs01
      Participant

      I was dx. 9/09 and had a WLE. The surgeon removed the melanoma (left back shoulder) taking 1cm margins, but when it healed, due to the shrinkage, it was less than that. My oncologisst also made a big deal of it and we checked the procedure notes to be sure 1cm margins were taken, which they were. The oncologist said that if I were trying to qualify for a trial, it would be required that the WLE had 1 cm margins. It turned out that I did not qualify for any trial at the time (I am IIIA), and I opted for 1 month high dose Interferon. I elected to leave the WLE as it was. I am currently NED, and hope to stay that way. I am not sure if it will come back to bite me or not!

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      patobs01
      Participant

      I was dx. 9/09 and had a WLE. The surgeon removed the melanoma (left back shoulder) taking 1cm margins, but when it healed, due to the shrinkage, it was less than that. My oncologisst also made a big deal of it and we checked the procedure notes to be sure 1cm margins were taken, which they were. The oncologist said that if I were trying to qualify for a trial, it would be required that the WLE had 1 cm margins. It turned out that I did not qualify for any trial at the time (I am IIIA), and I opted for 1 month high dose Interferon. I elected to leave the WLE as it was. I am currently NED, and hope to stay that way. I am not sure if it will come back to bite me or not!

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      Janner
      Participant

      Pretty much every pathology report I've ever seen doesn't mention the size taken by the surgeon – only the size the pathologist sees under the microscope.  That means, some shrinkage has already taken place.  So, worst case, it is 7mm (shrunken) instead of 1cm.  However, did your biopsy have clean margins?  Clean margins there might make up the tiny bit of extra margins you need.  Your lesion is low risk.  I, personally, would probably be content to just monitor the lesion.  If you had any pigment show up in the scar area, I would have it excised.  But I probably wouldn't have another excision for 2-3mm of tissue.  That would probably double the size of your scar – just to get the lesion to close.  However, you need to do what makes YOU comfortable – not the doctor or anyone else.

      Best wishes,

      Janner

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      Janner
      Participant

      Pretty much every pathology report I've ever seen doesn't mention the size taken by the surgeon – only the size the pathologist sees under the microscope.  That means, some shrinkage has already taken place.  So, worst case, it is 7mm (shrunken) instead of 1cm.  However, did your biopsy have clean margins?  Clean margins there might make up the tiny bit of extra margins you need.  Your lesion is low risk.  I, personally, would probably be content to just monitor the lesion.  If you had any pigment show up in the scar area, I would have it excised.  But I probably wouldn't have another excision for 2-3mm of tissue.  That would probably double the size of your scar – just to get the lesion to close.  However, you need to do what makes YOU comfortable – not the doctor or anyone else.

      Best wishes,

      Janner

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