SLNB for newly diagnosed T1b?

This topic has 8 replies, 7 voices, and was last updated 6 years, 4 months ago by spiderman.

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- December 26, 2017 at 7:50 pm
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PTgal
Participant
I was diagnosed with melanoma last week, and of course I have Googled myself into a frenzy. I am well aware of the masses of outdated information online, especially when it comes to indications for SNB.

The problematic mole had been on the lower right part of my abdomen since high school (I am currently 41.) Over this past summer, I noticed the mole had begun to feel slightly raised and itched occasionally. My doctor felt it was a “dysplastic nevus” and recommended to watch and wait. By early December, the mole was approximately 3/4 inch wide, was constantly itchy, and would become flaky at times. I had an excisional biopsy on December 18th which turned out to be maligninant melanoma.

Details of my pathology report included diagnosis of T1b as well as in situ melanoma with Breslow depth of 1.0 mm, Clark level IV, mitotic rate of 4/mm2, vertical growth phase. No ulceration identified. Lymphovascular involvement indeterminate.

I am scheduled to see a surgeon in two weeks to discuss WLE. My question is should I also advocate for a SNB? There seem to be significant differences of opinion for SNB in “thin” melanomas.

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- - December 26, 2017 at 8:18 pm
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  Nemesis
  Participant
  I would. Mine was T1b as well and asked for one and got it.
- - December 27, 2017 at 10:53 am
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  stars
  Participant
  It definitely should be discussed with a 1mm melanoma. Best info I could find:
  
  https://www.dermnetnz.org/topics/sentinel-lymph-node-biopsy/
- - December 27, 2017 at 12:43 pm
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  ed williams
  Participant
  Hi ptgal, here is the best discussion of path report with very good explaination of the various terms. I hope it will help to prepare for meeting with surgeon!!! Best Wishes!!!ED https://www.youtube.com/watch?v=2wmeyNjFKQw
  - December 27, 2017 at 3:32 pm
    
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    Cooper
    Participant
    
    Here's an easy to understand page on SLNB http://melanomainternational.org/melanoma-facts/sentinel-node-biopsy/#.WkO87lWnGM8
  - December 27, 2017 at 5:25 pm
    
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    ed williams
    Participant
    
    Not very detailed Anon, you could look for something with a little more detail like Dr. Jason Luke's talk on the topic.
- - December 29, 2017 at 3:07 pm
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  Bubbles
  Participant
  Hi ptgal. Sorry you are having to deal with and ponder these things. The info Ed shared with you is really good. Here is a post that addresses some issues and thoughts regarding SLNB with links to some additional research reports: http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2016/08/sentinel-lymph-node-disection-important.html
  
  Sadly, nothing is melanoma is super easy or straight forward!! However, there is a wealth of knowledge and support available from the peeps on this board. Hang in there. Keep us posted and ask questions when you need. Celeste
  - December 29, 2017 at 11:28 pm
    
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    PTgal
    Participant
    
    Thank you so much! I agreed with your blog post about SNB being a no brainier. I am definitely going to ask for it if it isn’t offered. I just don’t think I could ever rest without knowing for sure. Even though my Mel was “thin”, it certainly doesn’t mean it hasn’t spread, especially given my Clark level of IV. I would just rather be certain (or as certain as one can ever be with melanoma.) Now if I can just stay off Google….but I can’t. I’m obsessed. I just want to be armed with as much current information as possible just in case Mel decides to throw me a curve ball.
  - December 30, 2017 at 7:33 pm
    
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    spiderman
    Participant
    
    I was just like you in terms of scouring the web for any and all information but I did not do it until after my surgical procedures. I was caught by the “deer in the headlights” syndrome prior to that so I just went with the doctor’s recommendations. Had I known what I knew a few months later I would have done some things differently, so although I know that it is stressful it is best that you become educated as you are doing. Just try not to overdue things. There is a point at which the additional knowledge gets outweighed by the additional stress. My advice is to try to decide when you have reached that point and when you have back off and let things play out.