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Hello. I have had a spot on the back of my leg for several years. I wasn’t concerned about it b/c it looked identical to one I had below my chin that I had biopsied previously and was fine. Over the summer, my sister urged me to get the one on my leg checked out. I noticed at that time too that it did appear to be darkening in a spot and changing. Of course, I did not rush to the derm as I should have. I then had a mammogram in September that showed slightly swollen lymph nodes, which prompted a repeat diagnostic mammogram. Again, the lymph nodes were still slightly enlarged but the comments just said, “probably benign” and to repeat in several months. I was not thrilled w/ the words ‘probably benign’, but planned on repeating in several months. It then started making me wonder if this could be related to my leg, so finally got the spot checked, which turned out to be melanoma. It appears that the dermatologist got most of it off in the biopsy, but said I need to see a surgeon on Wednesday (thankfully so soon) to determine how deep the melanoma is. She said we will not know until after the surgeon. I guess I am confused since I have been reading how people know what stage melanoma is from the biopsy. It’s a bit confusing to me. I also am obviously concerned if my lymph nodes are affected.
My biopsy report says,
Biopsy Procedure: Biopsy, Shave. Invasiveness: invasive melanoma. Histologic: superficial spreading melanoma (low-cumulative sun damage melanoma). Maximum Tumor (breslow) thickness: At least .2mm. Ulceration: Not identified. Atotomic (Clark) Level: At least II (melanoma present in but does not fill and expand papillary dermis). Mitotic Rate 0/mm2; Microsatellites: Cannot be determined. Lymphovascular Invasion: Not identified. Margin Status for Invasive Melanoma: Deep Margin Positive. Margin Status for Melanoma in Sita: Peripheral and deep margins positive.
AJCC Stagine pT1a: Melanoma <0.8mm in thickness, no ulceration.
Comment: As the lesion extends to the base of the biopsy, the above measured depth is a minimum. Immunostains for S0X10 and Melan-A highlight the invasive and in situ melanoma. HMB45 is positive in the dermal component. Initial and multiple level sections were examined.
Please let me know if you have any insight or opinions from your experience and knowledge to share. Thanks so much.
I just tried to respond to you but I forget to mention I was not a robot, so my response failed and I have to type in again.
First, am sorry for this news for you and the anxiety it must cause you.
Second, I am not really an expert – there are others far better qualified on this board who can help you. ALso you can learn a lot by searching the forum (try shave biopsy there are old posts on this)
That said, my understanding from your biopsy is that it was a shave biopsy so they took off a small amount, a slither, and the melanoma extends to the base of the slither. So it is at least 0.2 mm deep. But they dont know the true depth yet. Thats why you have to go in for another biopsy. My guess is the next one will be an excision – I hope it will be done this wednesday but maybe this is just an initial appointment and it will be done soon. You may also have to have your lymph nodes checked so you can do a proper staging. (Again the experts can tell you better).
I think you are doing the right things, but do make sure you have a melanoma specialist on board, not just surgeons who take things out. You should talk to a melanoma oncologist I think. Unless you are stage I then my guess is you are OK. But for stage II and beyond talk w a melanoma specialist.
While this must be stressful for you, you are now doing the right things, and most of us here made the same mistakes especially at the start – not realising that we might have melanoma or skipping our dermatologist appointments. Also on the positive side, we now have much better treatments if you are stage II or beyond, that have benefitted many of us on this Board.
Please keep us posted and I hope our experts and others will be able to help you (as they helped and encouraged me!)
good luck and best wishes
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