More confusion over path reports/suggested treatment

OK, from the beginning.  My SIL had a shave biopsy of a lesion on her lower left leg.  Lesion had been slowly growing and developed some tiny black spots, but had not bled or seeped anything except for once when she caught it with her razor.  The pathology came back as:

"Comment:  It is not known if this is a biopsy of a larger lesion or an excisional biopsy.  Due to small size, fragmentation and orientation, the margins cannot be adequately evaluated.

OK, from the beginning.  My SIL had a shave biopsy of a lesion on her lower left leg.  Lesion had been slowly growing and developed some tiny black spots, but had not bled or seeped anything except for once when she caught it with her razor.  The pathology came back as:

"Comment:  It is not known if this is a biopsy of a larger lesion or an excisional biopsy.  Due to small size, fragmentation and orientation, the margins cannot be adequately evaluated.

Skin, Left Leg Lesion:  Received and labeled “lesion L leg,” is a .2 cm portion of dark brown-gray tissue that is submitted as received along with a smaller minute fragment.

Clinical info or preop diag:  None given

Microscopic Description:  The sections consist of levels of two tiny fragments of skin with a melanocytic lesion.  There is a lentigenous melanocytic proliferation;  focally the melanocytic cells are seen in the superficial portions of the epidermis.  Cytologic atypia is mild to moderate.  No mitoses are seen.  A few lymphocytes are seen in the underlying dermis.  Fragmentation and orientation preclude evaluation of the margins."

This report came back roughly 8 days after the biopsy.  Two days later, my SIL went to GP to get copy of the path report and ask for a referral to an oncologist with experience with melanoma.  By this time, she had developed an infection in the wound left from the shave biopsy.

Two days later, she is in the oncologist's office and he tells her that because of the path results and her age (47ish), they will plan to do a WLE and SNL biopsy.  He sends her upstairs to a surgeon who performs a complete excision of the lesion with "good" margins–that is how the doctor described it at the time of the bx.

Today, five days after the complete excision, she received this pathology report:

"Pathologic Diagnosis:

Skin lesion, left posterior cuff, excision:

1.  No diagnostic features of malignancy is identified (please see microscopic description).

2.  Ulceration, granulation tissue formation, intense chronic, acute inflammation, focal giant cell foreign body reactions, and reactive/reparative epidermal tissue changes.

3.  Surgical resection margins are evaluated, showing benign tissues.  LL/mv

Tissues:

1. LEFT LEG – MELANOMA LEFT POSTERIOR CALF

Clinical History:

Melanoma L posterior calf S/P shave bx.

Gross Description:

Received in formalin, labeled with the patient's corresponding requisition number, with accompanying requisition labeled "melanoma L posterior calf", is a pale tan, hairbearing, rubbery, wrinkled skin ellipse with overall dimensions of 2.5 x .7 x .5 cm.  On the skin's surface is a tan-brown to dark grey irregular area with overall dimensions of 7 x 7 mm.  Black ink is applied to the margin and the specimen is multiply cross-sectioned.  (1A – C – toto on edge for LX2) KLL/rkm

Microscopic Description:

Microscopic examination performed.  Sections show no diagnostic features of malignancy.  No in situ or invasive melanoma is identified.  Focal deep ulceration, granulation tissue formation, intense chronic and acute dermal inflammation are noted, at the presumptive previous biopsy site.  Giant cell foreign body reactions are present. Subjacent tissue showed reactive/reparative squamous epithelial changes.  Surgical resection margins are evaluated, showing benign tissues.  Further well-controlled immunohistochemical stain (1C) showed that the reactive epidermal tissue and skin adnexal epithelial tissues are positive for pancytokeratin, with S-100 protein and MART-1 negative for in situ or invasive melanoma.

The immunoperoxides stain was developed and its performance characteristics determined by the Pathology Department at Wesley Medical Center, Wichita, Kansas.  It has not been cleared or approved by the U.S. Food and Drug Administration."

When the doc gave her these results today, he insisted that she still needs to do the WLE and SNL bx.  Am I missing something?  Do you suppose they are worried that the shave biopsy might have sent melanome cells into the lymphatic system?  It seems to me that the SNL bx is a very aggressive decision.  Any advice and help with deciphering the report are greatly appreciated!!