› Forums › Cutaneous Melanoma Community › Newly Diagnosed- Need Afvice!
- This topic has 12 replies, 3 voices, and was last updated 9 years, 10 months ago by
Hignite.
- Post
-
- March 1, 2016 at 5:28 pm
I'm the aunt of a 26 year old female who was preliminary diagnosed two days by her dermatologist with Stage 1A melanoma , superficial spreading type. Breslow thickness 0.35 mm, Clarks level 111. Maximum tumor thickness 0.35 mm. mitotic rate, None identified. Tumor-infiltrating lymphocytes: Present, not brisk. Primary tumor.pT1a-melanoma 1 mm or less in thickness,no ulceration, less than 1 mitosis/mm. The incision was in the middle of her back.
she is returning to her dermatologist tomorrow. We are assuming to review her results and perhaps take more skin tissue. She will be armed with questions. I am a cancer survivor and believe in being as aggressive as possible in learning about diagnosis and treatment. She is my only niece!
Because of the Clarks level 111, is a sentinel lymph biopsy recommend? Would anyone recommend consulting an oncologist vs. wait and see? Are there any other tests recommended, MRI, brain scan??
Any insight would be greatly appreciated.
- Replies
-
-
- March 1, 2016 at 9:10 pm
Aren't you a great aunt! What a lucky girl, to have such switched-on family members. While a melanoma diagnosis is always a huge shock, your niece's pathology report is almost all good news in terms of a melanoma diagnosis. It has a very low chance of metastasising, and a great prognosis.
A stage 1A melanoma is very thin and only requires a 1cm wide local excision (1cm margin of healthy skin excised all around the melanoma. This will leave an 8-9 cm scar. It's done under local anaesthetic only and after 1-2 days of discomfort will heal within 2-3 weeks.
After that, just regular skin checks and vigilance. Nothing about your niece's pathology suggests an aggressive melanoma – it's thin, indolent and gone!
The clarks III is a surprise for such a thin melanoma – I guess that just relates to the site of the melanoma – I've had a similar thickness melanoma on my arm which reached stage II only. Clarks is kind of irrelevant except for very thin melanomas like your niece's – Breslow is far more important across the board. And your niece's Breslow at 0.35mm is nice and thin.
In Australia, 1mm is the cutoff for a SLNB – your niece won't be needing one as far as I know. Scans, no, nothing like that. An excision and vigilant monitoring.
A word of warning: many of us get more than one primary melanoma.If she hasn't already had it, she needs a really thorough skin check now, and then probably every six months. She might not have any more problems, but if she does, she wants to catch them early – preferably as severly dysplastic nevi or melanoma in situ, both of which have no metastatic potential.
-
- March 1, 2016 at 9:10 pm
Aren't you a great aunt! What a lucky girl, to have such switched-on family members. While a melanoma diagnosis is always a huge shock, your niece's pathology report is almost all good news in terms of a melanoma diagnosis. It has a very low chance of metastasising, and a great prognosis.
A stage 1A melanoma is very thin and only requires a 1cm wide local excision (1cm margin of healthy skin excised all around the melanoma. This will leave an 8-9 cm scar. It's done under local anaesthetic only and after 1-2 days of discomfort will heal within 2-3 weeks.
After that, just regular skin checks and vigilance. Nothing about your niece's pathology suggests an aggressive melanoma – it's thin, indolent and gone!
The clarks III is a surprise for such a thin melanoma – I guess that just relates to the site of the melanoma – I've had a similar thickness melanoma on my arm which reached stage II only. Clarks is kind of irrelevant except for very thin melanomas like your niece's – Breslow is far more important across the board. And your niece's Breslow at 0.35mm is nice and thin.
In Australia, 1mm is the cutoff for a SLNB – your niece won't be needing one as far as I know. Scans, no, nothing like that. An excision and vigilant monitoring.
A word of warning: many of us get more than one primary melanoma.If she hasn't already had it, she needs a really thorough skin check now, and then probably every six months. She might not have any more problems, but if she does, she wants to catch them early – preferably as severly dysplastic nevi or melanoma in situ, both of which have no metastatic potential.
-
- March 1, 2016 at 9:10 pm
Aren't you a great aunt! What a lucky girl, to have such switched-on family members. While a melanoma diagnosis is always a huge shock, your niece's pathology report is almost all good news in terms of a melanoma diagnosis. It has a very low chance of metastasising, and a great prognosis.
A stage 1A melanoma is very thin and only requires a 1cm wide local excision (1cm margin of healthy skin excised all around the melanoma. This will leave an 8-9 cm scar. It's done under local anaesthetic only and after 1-2 days of discomfort will heal within 2-3 weeks.
After that, just regular skin checks and vigilance. Nothing about your niece's pathology suggests an aggressive melanoma – it's thin, indolent and gone!
The clarks III is a surprise for such a thin melanoma – I guess that just relates to the site of the melanoma – I've had a similar thickness melanoma on my arm which reached stage II only. Clarks is kind of irrelevant except for very thin melanomas like your niece's – Breslow is far more important across the board. And your niece's Breslow at 0.35mm is nice and thin.
In Australia, 1mm is the cutoff for a SLNB – your niece won't be needing one as far as I know. Scans, no, nothing like that. An excision and vigilant monitoring.
A word of warning: many of us get more than one primary melanoma.If she hasn't already had it, she needs a really thorough skin check now, and then probably every six months. She might not have any more problems, but if she does, she wants to catch them early – preferably as severly dysplastic nevi or melanoma in situ, both of which have no metastatic potential.
-
- March 1, 2016 at 10:16 pm
I echo Stars post above. The WLE (wide local excision) to get 1cm margins is all that is needed for that lesion. It's considered a very low risk lesion. The SLNB is not recommended for a lesion like this – typically 1mm is the cutoff or having other higher risk factors. Stage 1a 0.35mm doesn't have any high risk factors. Most oncologists won't even see stage 1a individuals – once the WLE is done, her treatment is done. Her risk of getting another primary melanoma is actually higher than her risk for a recurrence – and even that is low. Less than 10% of melanoma warriors ever have a second melanoma primary. No scans will be done – again not warranted for such a low risk lesion. Regular derm visits will be the only followup required.
Janner
Stage 1b since 1992, 3 MM primaries
-
- March 1, 2016 at 10:16 pm
I echo Stars post above. The WLE (wide local excision) to get 1cm margins is all that is needed for that lesion. It's considered a very low risk lesion. The SLNB is not recommended for a lesion like this – typically 1mm is the cutoff or having other higher risk factors. Stage 1a 0.35mm doesn't have any high risk factors. Most oncologists won't even see stage 1a individuals – once the WLE is done, her treatment is done. Her risk of getting another primary melanoma is actually higher than her risk for a recurrence – and even that is low. Less than 10% of melanoma warriors ever have a second melanoma primary. No scans will be done – again not warranted for such a low risk lesion. Regular derm visits will be the only followup required.
Janner
Stage 1b since 1992, 3 MM primaries
-
- March 1, 2016 at 10:16 pm
I echo Stars post above. The WLE (wide local excision) to get 1cm margins is all that is needed for that lesion. It's considered a very low risk lesion. The SLNB is not recommended for a lesion like this – typically 1mm is the cutoff or having other higher risk factors. Stage 1a 0.35mm doesn't have any high risk factors. Most oncologists won't even see stage 1a individuals – once the WLE is done, her treatment is done. Her risk of getting another primary melanoma is actually higher than her risk for a recurrence – and even that is low. Less than 10% of melanoma warriors ever have a second melanoma primary. No scans will be done – again not warranted for such a low risk lesion. Regular derm visits will be the only followup required.
Janner
Stage 1b since 1992, 3 MM primaries
-
Tagged: cutaneous melanoma
- You must be logged in to reply to this topic.