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  • Post
    • April 15, 2016 at 11:05 pm
    brittanygrace23
    Participant

    Is it normal for them to remove a few lymph nodes at the same time as your excision as precaution? 

     

    My doctor wants to do that, but is it necessary? 

     

Viewing 2 reply threads
  • Replies
      • April 16, 2016 at 12:08 am
      Janner
      Participant

      It's called a Sentinel Lymph Node Biopsy, and depending on the depth of your lesion (should be listed in your pathology report), yes it is the standard protocol.  For very thin lesions, this isn't done but for lesions 1mm and deeper or for lesions that have other negative risk factors, it is the standard procedure.  It is to help with staging.  If they find melanoma in the lymph nodes, it will change your staging.

      • April 16, 2016 at 12:08 am
      Janner
      Participant

      It's called a Sentinel Lymph Node Biopsy, and depending on the depth of your lesion (should be listed in your pathology report), yes it is the standard protocol.  For very thin lesions, this isn't done but for lesions 1mm and deeper or for lesions that have other negative risk factors, it is the standard procedure.  It is to help with staging.  If they find melanoma in the lymph nodes, it will change your staging.

        • April 16, 2016 at 11:37 am
        brittanygrace23
        Participant

        Hi, 

        the depth was 0.58 mm, non ulcerated. But bc it was a shave and not puncture. The whole thing wide and depth was melanoma. The path report called in situ, but also stated histologic type was superficial spreading. Mitotic index was less 1 /mm2

        The only reason I am question the lymph nodes now is bc my local dermatologist removed 2 more suspicious moles today, said he wouldn't take lymph nodes and would just do excision. 

         

        Thanks for for any info. 

        • April 16, 2016 at 11:37 am
        brittanygrace23
        Participant

        Hi, 

        the depth was 0.58 mm, non ulcerated. But bc it was a shave and not puncture. The whole thing wide and depth was melanoma. The path report called in situ, but also stated histologic type was superficial spreading. Mitotic index was less 1 /mm2

        The only reason I am question the lymph nodes now is bc my local dermatologist removed 2 more suspicious moles today, said he wouldn't take lymph nodes and would just do excision. 

         

        Thanks for for any info. 

        • April 16, 2016 at 11:37 am
        brittanygrace23
        Participant

        Hi, 

        the depth was 0.58 mm, non ulcerated. But bc it was a shave and not puncture. The whole thing wide and depth was melanoma. The path report called in situ, but also stated histologic type was superficial spreading. Mitotic index was less 1 /mm2

        The only reason I am question the lymph nodes now is bc my local dermatologist removed 2 more suspicious moles today, said he wouldn't take lymph nodes and would just do excision. 

         

        Thanks for for any info. 

        • April 16, 2016 at 1:24 pm
        Janner
        Participant

        I'm confused. You say the whole thing was melanoma but the path report says in situ?  If it has a depth, it is not in situ.  Maybe it was in situ at the side margins?  Was the depth transsected?  Was the deep margin clear or involved?  Generally a SNB wouldn't be done on a stage 1a lesion like this.  But if the deep margin was involved, that means you don't know how deep the lesion really is.  Depth is how staging is determined and if a shave biopsy essentially cuts the lesion in two parts, you will never know the exact depth. (One reason why shave biopsies can be problematic if a lesion is melanoma.  It really helps if you post the entire path report, not bits and pieces because we are missing info here.  

        If the lesion has been bisected, This is one of those gray areas where it might make sense to do the SNB since you don't know the full depth.  However, this is your decision. As for your other moles removed, unless they are melanoma, there is no reason to do the SNB.  The wide excision is done (with smaller margins) for atypical lesions that aren't melanoma, but have atypical or dysplastic features.  

        • April 16, 2016 at 1:24 pm
        Janner
        Participant

        I'm confused. You say the whole thing was melanoma but the path report says in situ?  If it has a depth, it is not in situ.  Maybe it was in situ at the side margins?  Was the depth transsected?  Was the deep margin clear or involved?  Generally a SNB wouldn't be done on a stage 1a lesion like this.  But if the deep margin was involved, that means you don't know how deep the lesion really is.  Depth is how staging is determined and if a shave biopsy essentially cuts the lesion in two parts, you will never know the exact depth. (One reason why shave biopsies can be problematic if a lesion is melanoma.  It really helps if you post the entire path report, not bits and pieces because we are missing info here.  

        If the lesion has been bisected, This is one of those gray areas where it might make sense to do the SNB since you don't know the full depth.  However, this is your decision. As for your other moles removed, unless they are melanoma, there is no reason to do the SNB.  The wide excision is done (with smaller margins) for atypical lesions that aren't melanoma, but have atypical or dysplastic features.  

        • April 16, 2016 at 1:24 pm
        Janner
        Participant

        I'm confused. You say the whole thing was melanoma but the path report says in situ?  If it has a depth, it is not in situ.  Maybe it was in situ at the side margins?  Was the depth transsected?  Was the deep margin clear or involved?  Generally a SNB wouldn't be done on a stage 1a lesion like this.  But if the deep margin was involved, that means you don't know how deep the lesion really is.  Depth is how staging is determined and if a shave biopsy essentially cuts the lesion in two parts, you will never know the exact depth. (One reason why shave biopsies can be problematic if a lesion is melanoma.  It really helps if you post the entire path report, not bits and pieces because we are missing info here.  

        If the lesion has been bisected, This is one of those gray areas where it might make sense to do the SNB since you don't know the full depth.  However, this is your decision. As for your other moles removed, unless they are melanoma, there is no reason to do the SNB.  The wide excision is done (with smaller margins) for atypical lesions that aren't melanoma, but have atypical or dysplastic features.  

        • April 16, 2016 at 2:02 pm
        brittanygrace23
        Participant

        Is there a way to post a picture of my path report here? I'm using cellphone and don't see an option to upload from my pictures. 

         

         

        • April 16, 2016 at 2:02 pm
        brittanygrace23
        Participant

        Is there a way to post a picture of my path report here? I'm using cellphone and don't see an option to upload from my pictures. 

         

         

        • April 16, 2016 at 2:02 pm
        brittanygrace23
        Participant

        Is there a way to post a picture of my path report here? I'm using cellphone and don't see an option to upload from my pictures. 

         

         

        • April 16, 2016 at 2:04 pm
        brittanygrace23
        Participant

        I can send to you via email, send me an email

        brittanygrace23@yahoo.com

        • April 16, 2016 at 2:04 pm
        brittanygrace23
        Participant

        I can send to you via email, send me an email

        brittanygrace23@yahoo.com

        • April 16, 2016 at 2:04 pm
        brittanygrace23
        Participant

        I can send to you via email, send me an email

        brittanygrace23@yahoo.com

      • April 16, 2016 at 12:08 am
      Janner
      Participant

      It's called a Sentinel Lymph Node Biopsy, and depending on the depth of your lesion (should be listed in your pathology report), yes it is the standard protocol.  For very thin lesions, this isn't done but for lesions 1mm and deeper or for lesions that have other negative risk factors, it is the standard procedure.  It is to help with staging.  If they find melanoma in the lymph nodes, it will change your staging.

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