› Forums › General Melanoma Community › Questions about WLE
- This topic has 30 replies, 6 voices, and was last updated 9 years, 9 months ago by
hrisi930.
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- June 10, 2016 at 4:26 pm
Hello everyone!
I was recently diagnosed with minimal deviation melanoma, stage IA, Clark II, Breslow II (0.79).
The mole was removed by a plastic surgeon more than a month ago with elliptical excision, 4mm margins. The pathology report indicated clear margins.
The oncologists didn't say anything about WLE, they didn't even ask what were the surgical margins.
Just recently I read that there is a standard in melanoma WLE and that there should be 1cm margins for StageIA.
I might be overreacting, but all I want is to know that everything was done right.
The scar itself looks totally normal, however there is some tenderness that slmost feels like my melanoma used to (now I know this might be the result of my obsession that I need WLE).
So what do you think about that? I will greatly appreciate your comments!
All the best to all of you!
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- June 10, 2016 at 6:25 pm
I agree you should have had a WLE with 1cm margins. I seriously doubt that any discomfort you feel is related to the melanoma itself, only the WLE. WLE is precautionary and since you do have 4mm margins, chances are all the melanoma is removed. 1cm are recommended, however, to ensure any rogue cells are removed.
As for your discomfort, nerves are cut and skin is removed down to the muscle fascia. It can take up to a year for those areas to heal. It's common to have some discomfort after the fact and I wouldn't attribute that to anything other than normal healing.
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- June 10, 2016 at 6:25 pm
I agree you should have had a WLE with 1cm margins. I seriously doubt that any discomfort you feel is related to the melanoma itself, only the WLE. WLE is precautionary and since you do have 4mm margins, chances are all the melanoma is removed. 1cm are recommended, however, to ensure any rogue cells are removed.
As for your discomfort, nerves are cut and skin is removed down to the muscle fascia. It can take up to a year for those areas to heal. It's common to have some discomfort after the fact and I wouldn't attribute that to anything other than normal healing.
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- June 10, 2016 at 6:25 pm
I agree you should have had a WLE with 1cm margins. I seriously doubt that any discomfort you feel is related to the melanoma itself, only the WLE. WLE is precautionary and since you do have 4mm margins, chances are all the melanoma is removed. 1cm are recommended, however, to ensure any rogue cells are removed.
As for your discomfort, nerves are cut and skin is removed down to the muscle fascia. It can take up to a year for those areas to heal. It's common to have some discomfort after the fact and I wouldn't attribute that to anything other than normal healing.
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- June 10, 2016 at 7:59 pm
My dermatologist says anything over 1.0 on the Breslow scale requires the WLE. I believe that at .79 you had the correct procedure.
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- June 10, 2016 at 10:47 pm
Anything over 1.00 gets a sentinel lymph node biopsy. All lesions get WLE, no matter the size of the lesion. The margins vary with the size of the lesion.
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- June 10, 2016 at 10:47 pm
Anything over 1.00 gets a sentinel lymph node biopsy. All lesions get WLE, no matter the size of the lesion. The margins vary with the size of the lesion.
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- June 10, 2016 at 10:47 pm
Anything over 1.00 gets a sentinel lymph node biopsy. All lesions get WLE, no matter the size of the lesion. The margins vary with the size of the lesion.
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- June 10, 2016 at 7:59 pm
My dermatologist says anything over 1.0 on the Breslow scale requires the WLE. I believe that at .79 you had the correct procedure.
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- June 10, 2016 at 7:59 pm
My dermatologist says anything over 1.0 on the Breslow scale requires the WLE. I believe that at .79 you had the correct procedure.
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- June 10, 2016 at 8:55 pm
Thank you very much for your replies!
It is amazing how this forum can calm you down when you are worrying over something : )
What I understand is that there are different opinions about WLE – they are not sure if it reduces the risk of reocurrence but it is still recommended as a precaution.
I feel better now because but still a bit anxious. However, I have an appointment with my surgeon next week and I will discuss this with him to see what he has to say.
I think about pushing for the WLE since it can't hurt but I wonder if it will be totally pointless since the melanoma was removed over a month ago … it will be too late, I guess?
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- June 10, 2016 at 8:55 pm
Thank you very much for your replies!
It is amazing how this forum can calm you down when you are worrying over something : )
What I understand is that there are different opinions about WLE – they are not sure if it reduces the risk of reocurrence but it is still recommended as a precaution.
I feel better now because but still a bit anxious. However, I have an appointment with my surgeon next week and I will discuss this with him to see what he has to say.
I think about pushing for the WLE since it can't hurt but I wonder if it will be totally pointless since the melanoma was removed over a month ago … it will be too late, I guess?
-
- June 10, 2016 at 8:55 pm
Thank you very much for your replies!
It is amazing how this forum can calm you down when you are worrying over something : )
What I understand is that there are different opinions about WLE – they are not sure if it reduces the risk of reocurrence but it is still recommended as a precaution.
I feel better now because but still a bit anxious. However, I have an appointment with my surgeon next week and I will discuss this with him to see what he has to say.
I think about pushing for the WLE since it can't hurt but I wonder if it will be totally pointless since the melanoma was removed over a month ago … it will be too late, I guess?
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- June 10, 2016 at 9:15 pm
Hi
At .79 I would definitely get a WLE. I'm amazed it hasn't been offered. 4mm makes no sense to me – the standad is 2mm margin at initial surgical excision (eg, what gets cut out for biopsy), followed by a WLE with 0.5mm margin for stage 0 (in situ), 1cm for stage 1 etc. The fact that it's 1A is good news, but its a reasonable depth. In some clinics, if your mel had one worrying feature like ulceration (which it doesn't, otherwise you'd be 1B), you would come into focus for a possible SLNB, not just a WLE. The official depth for recommended SLNB is 1mm, but some doctors do them from 0.75mm upwards if the melanoma has aggressive features. A WLE is not pleasant but is a great insurance policy and in fact just straight out gold standard care (1cm margin for 1A). Perhaps get a second opinion because 4mm makes no sense to me, it's not even enough margin for a stage 0 melanoma let alone stage 1. BTW, there's every chance the WLE is totally clear, I wouldn't worry too much about finding anything but it's just standard protocol to get your treatment where it should be.
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- June 10, 2016 at 9:15 pm
Hi
At .79 I would definitely get a WLE. I'm amazed it hasn't been offered. 4mm makes no sense to me – the standad is 2mm margin at initial surgical excision (eg, what gets cut out for biopsy), followed by a WLE with 0.5mm margin for stage 0 (in situ), 1cm for stage 1 etc. The fact that it's 1A is good news, but its a reasonable depth. In some clinics, if your mel had one worrying feature like ulceration (which it doesn't, otherwise you'd be 1B), you would come into focus for a possible SLNB, not just a WLE. The official depth for recommended SLNB is 1mm, but some doctors do them from 0.75mm upwards if the melanoma has aggressive features. A WLE is not pleasant but is a great insurance policy and in fact just straight out gold standard care (1cm margin for 1A). Perhaps get a second opinion because 4mm makes no sense to me, it's not even enough margin for a stage 0 melanoma let alone stage 1. BTW, there's every chance the WLE is totally clear, I wouldn't worry too much about finding anything but it's just standard protocol to get your treatment where it should be.
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- June 10, 2016 at 9:31 pm
Thank you very much for your reply!
I will definitely require a WLE. The thing is that I've been to 3 oncologists and they didn't say anything about WLE nor did they recommend anything further.
One of them even said that the removal of a benign mole might metastize later as a melanoma?! After hearing this I became very frustrated because it is hard enough to be diagnosed with melanoma but not to be able to trust your doctors is overwhelming.
This is why I decided to take things in my own hands. I will go to my plastic surgeon and require WLE with 1cm margins and pay out of my pocket for the procedure. At least I will know that I did everything right.
However, I am a bit concerned about the timing… does anyone know if it is too late to do the WLE after 2 months?
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- June 10, 2016 at 9:31 pm
Thank you very much for your reply!
I will definitely require a WLE. The thing is that I've been to 3 oncologists and they didn't say anything about WLE nor did they recommend anything further.
One of them even said that the removal of a benign mole might metastize later as a melanoma?! After hearing this I became very frustrated because it is hard enough to be diagnosed with melanoma but not to be able to trust your doctors is overwhelming.
This is why I decided to take things in my own hands. I will go to my plastic surgeon and require WLE with 1cm margins and pay out of my pocket for the procedure. At least I will know that I did everything right.
However, I am a bit concerned about the timing… does anyone know if it is too late to do the WLE after 2 months?
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- June 10, 2016 at 10:15 pm
No. Probably no melanoma cells in the tissue around the lesion but if there is one or two cells, that is what you are trying to remove so they can't attempt to grow or travel further. Some people may wait 3 months to have the WLE to begin with based on scheduling. It's not too late.
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- June 10, 2016 at 10:15 pm
No. Probably no melanoma cells in the tissue around the lesion but if there is one or two cells, that is what you are trying to remove so they can't attempt to grow or travel further. Some people may wait 3 months to have the WLE to begin with based on scheduling. It's not too late.
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- June 10, 2016 at 10:15 pm
No. Probably no melanoma cells in the tissue around the lesion but if there is one or two cells, that is what you are trying to remove so they can't attempt to grow or travel further. Some people may wait 3 months to have the WLE to begin with based on scheduling. It's not too late.
-
- June 10, 2016 at 9:31 pm
Thank you very much for your reply!
I will definitely require a WLE. The thing is that I've been to 3 oncologists and they didn't say anything about WLE nor did they recommend anything further.
One of them even said that the removal of a benign mole might metastize later as a melanoma?! After hearing this I became very frustrated because it is hard enough to be diagnosed with melanoma but not to be able to trust your doctors is overwhelming.
This is why I decided to take things in my own hands. I will go to my plastic surgeon and require WLE with 1cm margins and pay out of my pocket for the procedure. At least I will know that I did everything right.
However, I am a bit concerned about the timing… does anyone know if it is too late to do the WLE after 2 months?
-
- June 10, 2016 at 9:15 pm
Hi
At .79 I would definitely get a WLE. I'm amazed it hasn't been offered. 4mm makes no sense to me – the standad is 2mm margin at initial surgical excision (eg, what gets cut out for biopsy), followed by a WLE with 0.5mm margin for stage 0 (in situ), 1cm for stage 1 etc. The fact that it's 1A is good news, but its a reasonable depth. In some clinics, if your mel had one worrying feature like ulceration (which it doesn't, otherwise you'd be 1B), you would come into focus for a possible SLNB, not just a WLE. The official depth for recommended SLNB is 1mm, but some doctors do them from 0.75mm upwards if the melanoma has aggressive features. A WLE is not pleasant but is a great insurance policy and in fact just straight out gold standard care (1cm margin for 1A). Perhaps get a second opinion because 4mm makes no sense to me, it's not even enough margin for a stage 0 melanoma let alone stage 1. BTW, there's every chance the WLE is totally clear, I wouldn't worry too much about finding anything but it's just standard protocol to get your treatment where it should be.
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Tagged: cutaneous melanoma
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