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Mitotic index follow up/ pathology report
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Mitotic index follow up/ pathology report

› Forums › General Melanoma Community › Mitotic index follow up/ pathology report

  • Post
    • May 3, 2013 at 2:18 pm
    mamabet
    Participant

      I am having a new primary excised next Wednesday.  In preparation for seeing my surgeon again, I thought I would go get a copy of my pathology report so that I can ask him for any services I have not yet received.  Please tell me if I need anything my oncologist has missed.

      Type:  Superficial Spreading Melanoma

      Tumour Thickness:  0.88mm

      Clark's Level:  IV

      Ulceration:  no ulceration identified

      Peripheral Margins:  uninvolved by invasive melanoma, closest margin is 4mm

      I am having a new primary excised next Wednesday.  In preparation for seeing my surgeon again, I thought I would go get a copy of my pathology report so that I can ask him for any services I have not yet received.  Please tell me if I need anything my oncologist has missed.

      Type:  Superficial Spreading Melanoma

      Tumour Thickness:  0.88mm

      Clark's Level:  IV

      Ulceration:  no ulceration identified

      Peripheral Margins:  uninvolved by invasive melanoma, closest margin is 4mm

      Deep Margin:  distance of invasive melanoma by margin is 16mm

      Mitotic Index:  less than 1/mm squared

      Microsatellitosis:  not identified

      Tumour-infiltrating Lymphocytes:  present, brisk

      Growth phase:  vertical

      ***  The following week I had a re-excision of the same spot.  No evidence of atypical melanocytes or residual malignant melanoma.  I also had a lymph node ultrasound, with normal-appearing lymph nodes bilaterally.  Chest x-ray was also normal.

      My surgeon is quite proactive, moreso than my oncologist.  He will order whatever tests I feel necessary.  I did not have a sentinal node biopsy, so with my mitotic index not being at 0, does anyone thiink this is necessary?

       

       

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    • Replies
        • May 3, 2013 at 4:25 pm
        Janner
        Participant

          The staging criteria calls out two categories:  <1 and 1+.  Yours is less than 1 so falls in the first (and best) category.

          You need to have the sentinel node biopsy done before the wide excision for it to have any meaning. Once you remove a large chunk of tissue (WLE), then the drainage paths might change and the SNB becomes suspect.  You might not get the same sentinel node after the excision that you would have got prior to the excision.  So it's really a little late for the SNB.  As for other tests, they typically aren't warranted for a stage IA lesion.

          Best wishes,

          Janner

            • May 3, 2013 at 4:40 pm
            mamabet
            Participant

              Perfect.  Thank you so much. 

              • May 3, 2013 at 4:40 pm
              mamabet
              Participant

                Perfect.  Thank you so much. 

                • May 3, 2013 at 4:40 pm
                mamabet
                Participant

                  Perfect.  Thank you so much. 

                • May 3, 2013 at 4:25 pm
                Janner
                Participant

                  The staging criteria calls out two categories:  <1 and 1+.  Yours is less than 1 so falls in the first (and best) category.

                  You need to have the sentinel node biopsy done before the wide excision for it to have any meaning. Once you remove a large chunk of tissue (WLE), then the drainage paths might change and the SNB becomes suspect.  You might not get the same sentinel node after the excision that you would have got prior to the excision.  So it's really a little late for the SNB.  As for other tests, they typically aren't warranted for a stage IA lesion.

                  Best wishes,

                  Janner

                  • May 3, 2013 at 4:25 pm
                  Janner
                  Participant

                    The staging criteria calls out two categories:  <1 and 1+.  Yours is less than 1 so falls in the first (and best) category.

                    You need to have the sentinel node biopsy done before the wide excision for it to have any meaning. Once you remove a large chunk of tissue (WLE), then the drainage paths might change and the SNB becomes suspect.  You might not get the same sentinel node after the excision that you would have got prior to the excision.  So it's really a little late for the SNB.  As for other tests, they typically aren't warranted for a stage IA lesion.

                    Best wishes,

                    Janner

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