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Questions/opinions on melanoma in situ on chest
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Questions/opinions on melanoma in situ on chest

› Forums › General Melanoma Community › Questions/opinions on melanoma in situ on chest

  • Post
    • November 30, 2016 at 1:32 am
    Michelle820
    Participant

      Hi:) I am a 43 female with a history of many basal cell skin cancers. I recently had an area of suspicion on my left breast area (12:00). It started as a tiny black dot that slowly enlarged. I had it biopsed and was informed that it was an early melanoma in situ. My pathology report was not very informative-just listing the diagnosis and some medical derm terminology. It did not list depth, ulceration, regression etc that I have read that reports should have. I was referred to a plastic surgeon for a Wide excision. My question is, would the second path report list the above info?

      My next concern was the location. Thankfully, the biopsy was pretty tiny, however, its in a slightly delicate spot. About 2 inches above the nipple (sorry tmi). I had a breast MRI a couple months ago because of having very dense breast tissue-luckily, it was negative. However, in my report it stated that there may be a "lymph node" present in the left breast at the 12:00 position***exactly the same location where my melanoma was removed. Ughhh. Do you think this is coincidental? I did decide to go back to see my breast specialist to get her opinion- she is also a surgeon. Thinking of having her do the excision also. Should I ask about the lymph node, and to ask if I can check it out during my excision, or am I being a hypochondriac because it was in-situ in the first biopsy? I appreciate any insight! Ty:)

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        • November 30, 2016 at 1:43 am
        Janner
        Participant

          In situ has a depth of zero and ulceration and regression would only be noted if they exist.  They aren't something you would typically find in an in situ lesion.  In situ is a Clark Level 0, 0 mitosis — there are lots of "implied" things with an in situ diagnosis and your report doesn't have to be detailed to tell you a lot.

          I'd say the lymph node was coincidental unless the biopsy was done prior to the MRI.  Surgery can cause things to temporarily swell — trauma.  I'd say removing the lymph node at the time of surgery woud probably be a bigger deal than you think but you can certainly ask your doc.  (Wide excisions are often done under local and doing something more invasive would most likely require general anesthesia).  In situ lesions are confined to the epidermis only.  Lymph and blood vessels are much deeper in the skin – that is why in situ has such a good prognosis.  It really lacks any vehicle to spread.

            • November 30, 2016 at 2:58 am
            Michelle820
            Participant

              Thank you for your reply and explains the path info. That makes sense now.

              I had the MRI back in September, and just had my skinbiopsy last week. 

              • November 30, 2016 at 2:58 am
              Michelle820
              Participant

                Thank you for your reply and explains the path info. That makes sense now.

                I had the MRI back in September, and just had my skinbiopsy last week. 

                • November 30, 2016 at 2:58 am
                Michelle820
                Participant

                  Thank you for your reply and explains the path info. That makes sense now.

                  I had the MRI back in September, and just had my skinbiopsy last week. 

                • November 30, 2016 at 1:43 am
                Janner
                Participant

                  In situ has a depth of zero and ulceration and regression would only be noted if they exist.  They aren't something you would typically find in an in situ lesion.  In situ is a Clark Level 0, 0 mitosis — there are lots of "implied" things with an in situ diagnosis and your report doesn't have to be detailed to tell you a lot.

                  I'd say the lymph node was coincidental unless the biopsy was done prior to the MRI.  Surgery can cause things to temporarily swell — trauma.  I'd say removing the lymph node at the time of surgery woud probably be a bigger deal than you think but you can certainly ask your doc.  (Wide excisions are often done under local and doing something more invasive would most likely require general anesthesia).  In situ lesions are confined to the epidermis only.  Lymph and blood vessels are much deeper in the skin – that is why in situ has such a good prognosis.  It really lacks any vehicle to spread.

                  • November 30, 2016 at 1:43 am
                  Janner
                  Participant

                    In situ has a depth of zero and ulceration and regression would only be noted if they exist.  They aren't something you would typically find in an in situ lesion.  In situ is a Clark Level 0, 0 mitosis — there are lots of "implied" things with an in situ diagnosis and your report doesn't have to be detailed to tell you a lot.

                    I'd say the lymph node was coincidental unless the biopsy was done prior to the MRI.  Surgery can cause things to temporarily swell — trauma.  I'd say removing the lymph node at the time of surgery woud probably be a bigger deal than you think but you can certainly ask your doc.  (Wide excisions are often done under local and doing something more invasive would most likely require general anesthesia).  In situ lesions are confined to the epidermis only.  Lymph and blood vessels are much deeper in the skin – that is why in situ has such a good prognosis.  It really lacks any vehicle to spread.

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