Newly diagnosed, pathology report help needed please.

Hi Mommyto2,

Does the path report state if the borders were clear? 

Hi – sorry to hear you got this news. I'll do my best to explain some of these terms. Firstly, now that you have had a melanoma, can I suggest that any future excisions be proper excisional biopsies not quick-and-easy-but-liable-to-bisect-melanoma shave biopsies?  Just a little bee in my bonnet that I have, the gold standard is excisional biopsies for suspected melanoma, not shaves because its too easy to bisect the base of the melanoma and in doing so destroy any chance of establishing true depth. Secondly, location: better to have melanoma on limbs than torso, but better torso than head/neck, so there's that. This is a fairly weak indicator of anything but I have read this somewhere. Thirdly, invasive. Not good, better to have in situ which means melanoma is confined to epidermis and nowhere near lymph and/or blood pathways that enable metastases. Invasive means that its spreading vertically and that might bring it into contact with blood/lymph and carry it to other parts of your body.  Nodular: also not good, considered to be more aggressive type than other types such as lentigo maligna melanoma or superficial spreading melanoma. Tumor thickness: 0.96mm – actually pretty thin, but close enough to the recommended 1mm cutoff to get a SLNB, so good that you are getting one. Also, the nodular aspect would warrant the SLNB given their reputation for being a little bit more aggressive. Anatomic level: IV. This is actually an older way of measuring melanoma depth, now it's only relevent to thin melanomas like yours. It does mean though that on a scale of I-IV, the melanoma has progressed deeper into the dermis. This only goes up to V (I being shallowest, V being deepest). Ulceration: not identified – this is great news. Ulceration is a poor prognostic sign. Mitotic rate: 5 – this is on the higher side, anything equal to or more than one is considered to be a poor prognostic sign.The main thing is, as someone below is trying to establish, is: is 0.96mm the actual complete depth, or did the shave biopsy cut off the base in which case you'll never know the true depth? If it is the actual complete depth it's actually pretty good news, despite all my humbugging. It would put your melanoma at the 'high risk' end of a 'low risk' lesion category. In other words, you have a low risk melanoma but slightly higher of a risk than say a thinner or non-nodular type with a lower mitotic rate. Depth is by far the most important variable, and yours is still pretty thin.