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New 2 Melanoma; Pathology report help

Forums General Melanoma Community New 2 Melanoma; Pathology report help

  • Post
    Dreaf01
    Participant

      Hi all, I was just diagnosed with Melanoma after a birthmark on my right outter thigh started changing colors during my recent pregnancy. I am so upset with myself for waiting, my OB just did not seem to concerned about it while I was in the hospital. Anyways fast forward, my son is now 7 months old and I cannot bear the thought of leaving him. I went to the dermatologist on 11/3-/16 and on 12/14/2016 I was told that I have Melanoma. I then went to a surgical oncologist to schedule a WLE and lymph node Bx for the 29th of this month. Since my diagnosis I have truly been FREAKING out. I have had dull chest pains that seem to bounce all over (Im hoping its anxiety) and have caught this cough that is going around. I havent been eating much and have a heard time sleeping at night. I have been a google freak and I am sure you all know that it does not help the anxiety at all. The surgical Oncologist says that right now I am a stage 2, until we get the path report back from the lymph node bx. Can you all interpret my pathology report and based on your knowledge tell me what you think?

      Malignant Melanoma without Ulceration

      Clark Level IV

      Breslow Thickness: 1.5mm

      Mitotic Rate: 4/mm2

      Histopathologic type: Unclassifiable

      Radial Growth Phase: The presence of Radial Growth Phase cannot be assessed as the in situ and invasive components of the tumor are present at the peripheral margin

      Vertical Growth Phase: Present

      Tumor cell Morphology: Epithelioid

      Regression: Absent

      Tumor Infiltration Lymphocytes: Non-Brisk

      Microscopic Satellites: Absent

      NeuroTropism: Absent

      A microscopic focus suspicious for angiolymphatic invasion noted.

      Any thoughts would be appreciated.

       

      Thanks

    Viewing 8 reply threads
    • Replies
        Janner
        Participant

          I think the surgical onc is wrong, you are stage 1b at the moment.  With no ulceration, stage 1b goes up to 2mm.  T2aN0M0 is stage 1b.

          https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

          The pieces in your report that relate to staging(prognostic indicators) are depth, ulceration and mitosis.  Your depth is considered intermediate (1-4mm).  Ulceration is absent  – good.  Mitosis is 4.  Preferably it would be 0.  4 would probably also be intermediate.  That is the rate at which cells are dividing.  The only thing not noted is if the deep margin is clear.  Since it is noted the peripheral margins are not clear, I'm assuming the deep is clear or it would have been noted.

          At this point, there is nothing to research and nothing to do except wait.  You'll have plenty of time to research later when you know the results of your SNB.  Until then, it is pointless.  One way you basically move on and the other you may consider treatments or trials.  But going there ahead of time is not a productive way to spend time.  You have a new baby and it's the holidays!  Ignore the rest until you have to deal with it.  Googling is not your friend at this point.

          Janner
          Participant

            I think the surgical onc is wrong, you are stage 1b at the moment.  With no ulceration, stage 1b goes up to 2mm.  T2aN0M0 is stage 1b.

            https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

            The pieces in your report that relate to staging(prognostic indicators) are depth, ulceration and mitosis.  Your depth is considered intermediate (1-4mm).  Ulceration is absent  – good.  Mitosis is 4.  Preferably it would be 0.  4 would probably also be intermediate.  That is the rate at which cells are dividing.  The only thing not noted is if the deep margin is clear.  Since it is noted the peripheral margins are not clear, I'm assuming the deep is clear or it would have been noted.

            At this point, there is nothing to research and nothing to do except wait.  You'll have plenty of time to research later when you know the results of your SNB.  Until then, it is pointless.  One way you basically move on and the other you may consider treatments or trials.  But going there ahead of time is not a productive way to spend time.  You have a new baby and it's the holidays!  Ignore the rest until you have to deal with it.  Googling is not your friend at this point.

              Dreaf01
              Participant

                Thank you for your quick response.

                Dreaf01
                Participant

                  Thank you for your quick response.

                  Dreaf01
                  Participant

                    Thank you for your quick response.

                  Janner
                  Participant

                    I think the surgical onc is wrong, you are stage 1b at the moment.  With no ulceration, stage 1b goes up to 2mm.  T2aN0M0 is stage 1b.

                    https://www.melanoma.org/understand-melanoma/diagnosing-melanoma/stages-of-diagnosis

                    The pieces in your report that relate to staging(prognostic indicators) are depth, ulceration and mitosis.  Your depth is considered intermediate (1-4mm).  Ulceration is absent  – good.  Mitosis is 4.  Preferably it would be 0.  4 would probably also be intermediate.  That is the rate at which cells are dividing.  The only thing not noted is if the deep margin is clear.  Since it is noted the peripheral margins are not clear, I'm assuming the deep is clear or it would have been noted.

                    At this point, there is nothing to research and nothing to do except wait.  You'll have plenty of time to research later when you know the results of your SNB.  Until then, it is pointless.  One way you basically move on and the other you may consider treatments or trials.  But going there ahead of time is not a productive way to spend time.  You have a new baby and it's the holidays!  Ignore the rest until you have to deal with it.  Googling is not your friend at this point.

                    ToddG
                    Participant

                      I agree with Janner.  I was recently diagnosed with stage III metastatic melanoma (eve of Thanksgiving) and am currenly in a wait-and-see pattern as results of different tests have not come in yet.

                      Love life and love that baby!  This forum is great for encouragement and I urge you, if you need to be on the internet, concerned about your diagnosis, spend your time here.  I, too, spent quite a bit of time googling, but all that did was make me crazy.  We are going to beat this!

                      ToddG
                      Participant

                        I agree with Janner.  I was recently diagnosed with stage III metastatic melanoma (eve of Thanksgiving) and am currenly in a wait-and-see pattern as results of different tests have not come in yet.

                        Love life and love that baby!  This forum is great for encouragement and I urge you, if you need to be on the internet, concerned about your diagnosis, spend your time here.  I, too, spent quite a bit of time googling, but all that did was make me crazy.  We are going to beat this!

                        ToddG
                        Participant

                          I agree with Janner.  I was recently diagnosed with stage III metastatic melanoma (eve of Thanksgiving) and am currenly in a wait-and-see pattern as results of different tests have not come in yet.

                          Love life and love that baby!  This forum is great for encouragement and I urge you, if you need to be on the internet, concerned about your diagnosis, spend your time here.  I, too, spent quite a bit of time googling, but all that did was make me crazy.  We are going to beat this!

                            Dreaf01
                            Participant

                              Yes, I love the encouragement. I need it everyday and everytime I look at my baby. The anxiety is unreal! I literally go crazy everytime I get the smallest pain, and Im sure they are all due to excess loads of anxiety. Well wishes to you and thank you for takinf the time out to respond.

                               

                              Dreaf01
                              Participant

                                Yes, I love the encouragement. I need it everyday and everytime I look at my baby. The anxiety is unreal! I literally go crazy everytime I get the smallest pain, and Im sure they are all due to excess loads of anxiety. Well wishes to you and thank you for takinf the time out to respond.

                                 

                                Dreaf01
                                Participant

                                  Yes, I love the encouragement. I need it everyday and everytime I look at my baby. The anxiety is unreal! I literally go crazy everytime I get the smallest pain, and Im sure they are all due to excess loads of anxiety. Well wishes to you and thank you for takinf the time out to respond.

                                   

                                  keepthefaith11
                                  Participant
                                    I agree with the other posters. Please don’t spend time searching Google. Especially since all of the stats are completely outdated. Many of the things in your report or favorable,including no ulceration. Try to stay positive. You don’t want to look back on this time of your baby’s life thinking you did not cherish each moment with him. Thinking about this changes nothing. I have young children myself (7 and 9) and time flies by so quickly that I want to soak in every moment I have with them. Your baby will never be 7 months again. You will come out of this and might never have to deal with melanoma again. Don’t let it take over your life right now. Enjoy the holidays with your family!

                                    Annie

                                    keepthefaith11
                                    Participant
                                      I agree with the other posters. Please don’t spend time searching Google. Especially since all of the stats are completely outdated. Many of the things in your report or favorable,including no ulceration. Try to stay positive. You don’t want to look back on this time of your baby’s life thinking you did not cherish each moment with him. Thinking about this changes nothing. I have young children myself (7 and 9) and time flies by so quickly that I want to soak in every moment I have with them. Your baby will never be 7 months again. You will come out of this and might never have to deal with melanoma again. Don’t let it take over your life right now. Enjoy the holidays with your family!

                                      Annie

                                      Sophietx
                                      Participant

                                        Sorry that you have to deal with this!!! I am 40 years old   and have been diagnosed with 2 cancers this year. Wow – I still can't believe it. I am very heathy looking – ha, ha:-) work out regularly and very active life style. Non of these cancers are genetic – had genetic testing at major cancer hospital in TX. Nobody from my family ever had these cancers. 1st cancer stage 1 and 2nd stage 0. I had the same symptoms as you. I think it's an anxiety. I woke one day and said: I will be a victim or a survivor. I never told my kids 15 and almost 13 year old.  My husband pretty much told me: my cancer is not his concern. Wow that was another shock. Still not sure how to deal with that. But as for now I am living… since my 1st cancer I have took beautiful vacations with my kids: Europe, Cayman Island, Disney World… I went to Cayman Island one week after WLE… life is too short. Non of us know how long left we have. The best is to love every day!!! You need to pick yourself up. You are a mom and your baby needs you. You only have 2 choices be a victim or survivor! I am from Europe so no family at all around…big hug!!!

                                        Dreaf01
                                        Participant
                                          Wow! The stress of this one diagnosis is disabling and I only have half of the diagnosis. I cant imagine having 2! I am trying so hard to focus on today, but my mind keeps dragging me down the what if path. I will be praying 4 you all! Best wishes & Merry Christmas
                                          Dreaf01
                                          Participant
                                            Wow! The stress of this one diagnosis is disabling and I only have half of the diagnosis. I cant imagine having 2! I am trying so hard to focus on today, but my mind keeps dragging me down the what if path. I will be praying 4 you all! Best wishes & Merry Christmas
                                            Sophietx
                                            Participant

                                              It is not easy but you will see that your life will settle down again. You need to make yourself busy as possible. I think this year might be my worst or luckiest. Only time will tell. I didn't have to have any other treatment for either cancer other than surgery. I wasn't even send to see an oncologist. Crazy, isn't it? My life has changed. I wake up every day and try to be the best person I can be. Nothing else matters. I have connected with other women who have had multiple cancers 15 years ago and living healthy. Since my melanoma was only in situ – not invasive I am not as focused on it. I will do the mole mapping and will be monitored. I am glad this happened to me and not my kids.

                                              Sophietx
                                              Participant

                                                It is not easy but you will see that your life will settle down again. You need to make yourself busy as possible. I think this year might be my worst or luckiest. Only time will tell. I didn't have to have any other treatment for either cancer other than surgery. I wasn't even send to see an oncologist. Crazy, isn't it? My life has changed. I wake up every day and try to be the best person I can be. Nothing else matters. I have connected with other women who have had multiple cancers 15 years ago and living healthy. Since my melanoma was only in situ – not invasive I am not as focused on it. I will do the mole mapping and will be monitored. I am glad this happened to me and not my kids.

                                                Sophietx
                                                Participant

                                                  It is not easy but you will see that your life will settle down again. You need to make yourself busy as possible. I think this year might be my worst or luckiest. Only time will tell. I didn't have to have any other treatment for either cancer other than surgery. I wasn't even send to see an oncologist. Crazy, isn't it? My life has changed. I wake up every day and try to be the best person I can be. Nothing else matters. I have connected with other women who have had multiple cancers 15 years ago and living healthy. Since my melanoma was only in situ – not invasive I am not as focused on it. I will do the mole mapping and will be monitored. I am glad this happened to me and not my kids.

                                                  Dreaf01
                                                  Participant
                                                    Wow! The stress of this one diagnosis is disabling and I only have half of the diagnosis. I cant imagine having 2! I am trying so hard to focus on today, but my mind keeps dragging me down the what if path. I will be praying 4 you all! Best wishes & Merry Christmas
                                                    Sophietx
                                                    Participant

                                                      Sorry that you have to deal with this!!! I am 40 years old   and have been diagnosed with 2 cancers this year. Wow – I still can't believe it. I am very heathy looking – ha, ha:-) work out regularly and very active life style. Non of these cancers are genetic – had genetic testing at major cancer hospital in TX. Nobody from my family ever had these cancers. 1st cancer stage 1 and 2nd stage 0. I had the same symptoms as you. I think it's an anxiety. I woke one day and said: I will be a victim or a survivor. I never told my kids 15 and almost 13 year old.  My husband pretty much told me: my cancer is not his concern. Wow that was another shock. Still not sure how to deal with that. But as for now I am living… since my 1st cancer I have took beautiful vacations with my kids: Europe, Cayman Island, Disney World… I went to Cayman Island one week after WLE… life is too short. Non of us know how long left we have. The best is to love every day!!! You need to pick yourself up. You are a mom and your baby needs you. You only have 2 choices be a victim or survivor! I am from Europe so no family at all around…big hug!!!

                                                      Sophietx
                                                      Participant

                                                        Sorry that you have to deal with this!!! I am 40 years old   and have been diagnosed with 2 cancers this year. Wow – I still can't believe it. I am very heathy looking – ha, ha:-) work out regularly and very active life style. Non of these cancers are genetic – had genetic testing at major cancer hospital in TX. Nobody from my family ever had these cancers. 1st cancer stage 1 and 2nd stage 0. I had the same symptoms as you. I think it's an anxiety. I woke one day and said: I will be a victim or a survivor. I never told my kids 15 and almost 13 year old.  My husband pretty much told me: my cancer is not his concern. Wow that was another shock. Still not sure how to deal with that. But as for now I am living… since my 1st cancer I have took beautiful vacations with my kids: Europe, Cayman Island, Disney World… I went to Cayman Island one week after WLE… life is too short. Non of us know how long left we have. The best is to love every day!!! You need to pick yourself up. You are a mom and your baby needs you. You only have 2 choices be a victim or survivor! I am from Europe so no family at all around…big hug!!!

                                                        keepthefaith11
                                                        Participant
                                                          I agree with the other posters. Please don’t spend time searching Google. Especially since all of the stats are completely outdated. Many of the things in your report or favorable,including no ulceration. Try to stay positive. You don’t want to look back on this time of your baby’s life thinking you did not cherish each moment with him. Thinking about this changes nothing. I have young children myself (7 and 9) and time flies by so quickly that I want to soak in every moment I have with them. Your baby will never be 7 months again. You will come out of this and might never have to deal with melanoma again. Don’t let it take over your life right now. Enjoy the holidays with your family!

                                                          Annie

                                                          Nemesis
                                                          Participant

                                                            Any news? I know you had your surgery on the same day as I. Did you get your report back yet?

                                                             

                                                            Nemesis
                                                            Participant

                                                              Any news? I know you had your surgery on the same day as I. Did you get your report back yet?

                                                               

                                                              Dreaf01
                                                              Participant
                                                                So sorry that I am just now seeing this. Margins were clear, they removed 2 lymph nodes which were negative (thank goodness), however major anxiety has taken over my life and I freak out about everything. Hoping it gets better with time. How did your surgery go? Results?
                                                                Dreaf01
                                                                Participant
                                                                  So sorry that I am just now seeing this. Margins were clear, they removed 2 lymph nodes which were negative (thank goodness), however major anxiety has taken over my life and I freak out about everything. Hoping it gets better with time. How did your surgery go? Results?
                                                                  Dreaf01
                                                                  Participant
                                                                    So sorry that I am just now seeing this. Margins were clear, they removed 2 lymph nodes which were negative (thank goodness), however major anxiety has taken over my life and I freak out about everything. Hoping it gets better with time. How did your surgery go? Results?
                                                                    Nemesis
                                                                    Participant

                                                                      Any news? I know you had your surgery on the same day as I. Did you get your report back yet?

                                                                       

                                                                    stars
                                                                    Participant

                                                                      Hi

                                                                      I won't try to analyse your path report as others here are much better at that than me, but I wanted to speak about anxiety.  I think what you are experiencing is pretty normal for a parent – I know the first thing I thought of when diagnosed was my young kids… it was the hardest thing, my mind running away on me, wondering if I'd be around for them, and even just in the short term keeping them away from excision or WLE sites etc. I think there is just an awful phase of anxiety and you are in it, especially as you are still waiting on your SLNB and the results from that. I wish I had good advice around this but I really don't – I had the same. The good news is that time is a great healer and as the weeks go by you will be in a much better place mentally and physically. This board helps – though some would say if you get the all clear then just go live life, don't hang around reading about others stories. Keeping busy/focusing on business-as-usual with your life is also important. I personally became more prayerful and explored my faith more – that's been a gift and in that way melanoma has been a blessing in disguise. Some calls to a cancer psychologist can also help –  that's often a free service, and I'm sure you can find similar – they will give you tools to cope with anxiety. All the best and it goes without saying I will be praying for you.

                                                                      stars
                                                                      Participant

                                                                        Hi

                                                                        I won't try to analyse your path report as others here are much better at that than me, but I wanted to speak about anxiety.  I think what you are experiencing is pretty normal for a parent – I know the first thing I thought of when diagnosed was my young kids… it was the hardest thing, my mind running away on me, wondering if I'd be around for them, and even just in the short term keeping them away from excision or WLE sites etc. I think there is just an awful phase of anxiety and you are in it, especially as you are still waiting on your SLNB and the results from that. I wish I had good advice around this but I really don't – I had the same. The good news is that time is a great healer and as the weeks go by you will be in a much better place mentally and physically. This board helps – though some would say if you get the all clear then just go live life, don't hang around reading about others stories. Keeping busy/focusing on business-as-usual with your life is also important. I personally became more prayerful and explored my faith more – that's been a gift and in that way melanoma has been a blessing in disguise. Some calls to a cancer psychologist can also help –  that's often a free service, and I'm sure you can find similar – they will give you tools to cope with anxiety. All the best and it goes without saying I will be praying for you.

                                                                        stars
                                                                        Participant

                                                                          Hi

                                                                          I won't try to analyse your path report as others here are much better at that than me, but I wanted to speak about anxiety.  I think what you are experiencing is pretty normal for a parent – I know the first thing I thought of when diagnosed was my young kids… it was the hardest thing, my mind running away on me, wondering if I'd be around for them, and even just in the short term keeping them away from excision or WLE sites etc. I think there is just an awful phase of anxiety and you are in it, especially as you are still waiting on your SLNB and the results from that. I wish I had good advice around this but I really don't – I had the same. The good news is that time is a great healer and as the weeks go by you will be in a much better place mentally and physically. This board helps – though some would say if you get the all clear then just go live life, don't hang around reading about others stories. Keeping busy/focusing on business-as-usual with your life is also important. I personally became more prayerful and explored my faith more – that's been a gift and in that way melanoma has been a blessing in disguise. Some calls to a cancer psychologist can also help –  that's often a free service, and I'm sure you can find similar – they will give you tools to cope with anxiety. All the best and it goes without saying I will be praying for you.

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