Pathology report details for my new melanoma

This topic has 16 replies, 5 voices, and was last updated 12 years, 11 months ago by eaca.

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- May 20, 2011 at 10:13 pm
- Quote
eaca
Participant
I promised an update for those interested on my first doctor consultation today. Here are the details of the pathology report on the mole that was removed – I don't even pretend to understand everything, but I know there are very knowledgeable people here who will!

"Melanoma, invasive, superficial spreading type

Clark Level, III

Breslow Thickness, 3.20 mm

Radial (non-tumorigenic) growth phase, present

Vertical (tumorigenic) growth phase, present

Mitotic Figures/mm2, 25

Ulceration, Present (1.5mm)

Regression, not identified

I promised an update for those interested on my first doctor consultation today. Here are the details of the pathology report on the mole that was removed – I don't even pretend to understand everything, but I know there are very knowledgeable people here who will!

"Melanoma, invasive, superficial spreading type

Clark Level, III

Breslow Thickness, 3.20 mm

Radial (non-tumorigenic) growth phase, present

Vertical (tumorigenic) growth phase, present

Mitotic Figures/mm2, 25

Ulceration, Present (1.5mm)

Regression, not identified

Vascular Invasion, not ruled out

Perineural Invasion, not identified

Microscopic Satellitosis, not identified

Tumor-Infiltrating Lymphocytes, Non Brisk

Associated Melanocytic Nevus, Present (Intradermal Nevus)

Predominant Cytology, Epithelioid

Surgical Margins: Melanoma in situ is present within 1.0mm of peripheral tissue edges

Comment: Sections show invasive melanoma, polypoid and ulcerated. There is a small aggregate of nevoid melanocytic cells in the base of the tumor, interpreted as an associated intradermal nevus.

Additional material will be requested to perform an immunohistochemical study for D2-40 to rule out vascular invasion. An addendum will follow."

I felt the doctor and her assistant's were quite good at explaining things. After meeting with them I had a Lymphoscintigraphy done, blood collected, EKG and chest Xray done. The technician at the lymphoscintigraphy said that the site was draining to my left axilla. I am supposed to get a call on Monday with the results and to determine whether the doctor wants an ultrasound done before the surgery.

I am scheduled to have the wide excision of the site along with the sentinal node biopsy done on June 8 (earliest available date).

All of this is quite scary. The melanoma is deeper and more active than I had hoped for. Still, the doctor said there was only a 1 in 4 chance that any melanoma would be found in the lymph nodes, so I'll hope for a good outcome after the surgery. The hardest part will be the waiting to find out.

I had been planning to spend almost the whole summer in France (where I moved from last year). Now I have to delay my departure, but the doctor said that she thinks I can travel after the surgery and while waiting for the results. She wouldn't do a second surgery if needed until 1 month after the first anyway. Do you all think it's realistic that I could travel after the first surgery?

Thanks for your interest in reading these sordid details!

Elisa

Viewing 7 reply threads

Replies

- - May 20, 2011 at 11:24 pm
  - Quote
  washoegal
  Participant
  Others are much better at reading the Path reports so I'll let them do that. What I can tell you is that I went on a Cruise less than a week after I had my SNB and WLE. I have to admit that I didn't have all my energy back but that was about the only problem. That and I didn't go swimming on any beaches.
  
  Good Luck
  
  Mary
  
  Stage 3
  - May 21, 2011 at 1:30 am
    
    Quote
    washoegal
    Participant
    
    Good poin about the location my WLE was on the waist and the lymph nodes were under the arm.
  - May 21, 2011 at 1:30 am
    
    Quote
    washoegal
    Participant
    
    Good poin about the location my WLE was on the waist and the lymph nodes were under the arm.
- - May 20, 2011 at 11:24 pm
  - Quote
  washoegal
  Participant
  Others are much better at reading the Path reports so I'll let them do that. What I can tell you is that I went on a Cruise less than a week after I had my SNB and WLE. I have to admit that I didn't have all my energy back but that was about the only problem. That and I didn't go swimming on any beaches.
  
  Good Luck
  
  Mary
  
  Stage 3
- - May 21, 2011 at 12:12 am
  - Quote
  Ranisa
  Participant
  I think that it depends on where your WLE and SNB will be. I had my WLE on my right calf and SNB was in the groin on the same leg…with a skin graft. After a week I could hobble around Target, and that was it.
  - May 21, 2011 at 4:44 pm
    
    Quote
    eaca
    Participant
    
    Yes, good point. My WLE will be in the middle of my upper back and the SNB in my left armpit.
    
    Thanks for letting me know your experiences with travel after this!
  - May 21, 2011 at 4:44 pm
    
    Quote
    eaca
    Participant
    
    Yes, good point. My WLE will be in the middle of my upper back and the SNB in my left armpit.
    
    Thanks for letting me know your experiences with travel after this!
- - May 21, 2011 at 12:12 am
  - Quote
  Ranisa
  Participant
  I think that it depends on where your WLE and SNB will be. I had my WLE on my right calf and SNB was in the groin on the same leg…with a skin graft. After a week I could hobble around Target, and that was it.
- - May 22, 2011 at 9:22 pm
  - Quote
  KatyWI
  Participant
  I think it's quite possible to travel after WLE/SNB to the axilla. I think took all of one day off of work for mine (though I had the weekend to recover). I think my only limitation was needing to go back in five days to have the stitches removed. However, when they did my SNB they did a quick frozen section on the node; if they had found mm at that point, the surgeon would have continued to do the full lymph node dissection. Is that a possible outcome for you? I ended up having my full LND later, because while the frozen section looked good, the more thorough pathology identified a met. After LND, travel was impossible for a little while because of the drain.
  
  Also, my surgeon recommended I avoid flying for a little while as I was healing up from the full dissection, believing that the pressure changes could provoke lympedema. I did avoid flying for about a year. If you end up needing the full dissection, maybe you could ask your surgeon about a compression garment to wear during the flight to reduce the risk of any problems.
  
  My hope for you is that the SNB comes out just peachy and you can relish your time in France! Best wishes,
  
  KatyWI
  - May 23, 2011 at 3:24 am
    
    Quote
    eaca
    Participant
    
    KatyWI,
    
    Thanks for the advice and sharing your experience. I know I will have to remain flexible and ready for last minute changes depending on what the Dr. finds when she goes in there. Right now I'm hoping and planning for an easy, good outcome and therefore chance to go to France soon afterwards. But if it isn't to be, then I'll deal with that too. It would be a real bummer though…
  - May 23, 2011 at 3:24 am
    
    Quote
    eaca
    Participant
    
    KatyWI,
    
    Thanks for the advice and sharing your experience. I know I will have to remain flexible and ready for last minute changes depending on what the Dr. finds when she goes in there. Right now I'm hoping and planning for an easy, good outcome and therefore chance to go to France soon afterwards. But if it isn't to be, then I'll deal with that too. It would be a real bummer though…
- - May 22, 2011 at 9:22 pm
  - Quote
  KatyWI
  Participant
  I think it's quite possible to travel after WLE/SNB to the axilla. I think took all of one day off of work for mine (though I had the weekend to recover). I think my only limitation was needing to go back in five days to have the stitches removed. However, when they did my SNB they did a quick frozen section on the node; if they had found mm at that point, the surgeon would have continued to do the full lymph node dissection. Is that a possible outcome for you? I ended up having my full LND later, because while the frozen section looked good, the more thorough pathology identified a met. After LND, travel was impossible for a little while because of the drain.
  
  Also, my surgeon recommended I avoid flying for a little while as I was healing up from the full dissection, believing that the pressure changes could provoke lympedema. I did avoid flying for about a year. If you end up needing the full dissection, maybe you could ask your surgeon about a compression garment to wear during the flight to reduce the risk of any problems.
  
  My hope for you is that the SNB comes out just peachy and you can relish your time in France! Best wishes,
  
  KatyWI
- - May 23, 2011 at 2:32 am
  - Quote
  gtown
  Participant
  Hey Elisa,
  
  I just had nodular melanopma removed from my shoulder with a SLN in the armpit area last Wednesday. I ran 3 miles Fri, worked Sat and another 9 miles this morning. Armpit was sore for about 2 days but other than that no problem, so enjoy France. Hang in there, I'm awaiting biopsy results myself so I can relate to what you're going through.
  
  Gtown
  - May 23, 2011 at 3:20 am
    
    Quote
    eaca
    Participant
    
    Wow, that's very impressive and encouraging! Thanks for sharing.
  - May 23, 2011 at 3:20 am
    
    Quote
    eaca
    Participant
    
    Wow, that's very impressive and encouraging! Thanks for sharing.
- - May 23, 2011 at 2:32 am
  - Quote
  gtown
  Participant
  Hey Elisa,
  
  I just had nodular melanopma removed from my shoulder with a SLN in the armpit area last Wednesday. I ran 3 miles Fri, worked Sat and another 9 miles this morning. Armpit was sore for about 2 days but other than that no problem, so enjoy France. Hang in there, I'm awaiting biopsy results myself so I can relate to what you're going through.
  
  Gtown