So good to find a Melonoma Patient Forum

Sorry for your need to be here, but welcome!  I am glad you/your docs found your lesion so early!  The earlier found, the better the prognosis is for melanoma.  For an explanation, which I think you are asking for…

Given the shave biopsy, it is clear that all the melanoma lesion has not been removed.  Therefore, a WLE (wide local excision) is required to remove all of the melanoma and gain clear margins all around.  At the same time, sentinel lymph nodes (nodes that light up when a tracer dye is injected at the site of the lesion) will be removed.  There are usually somewhere between 1-3.  We have learned that removing all the nodes in the area  is NOT needed and does not prolong life.  However, removing and testing the sentinel node is necessary so that you can know what stage of melanoma you have.  If the nodes are clear – YAY!!!!!!!!!!!!!!!  You would most likely be Stage I.   As such, you would be unlikely to need any treatment other than follow-up skin checks.  However, if you have a positive node, you would be Stage III and in need of further examination and to consider systemic treatment.

If you like deets and research, here is a post and article that explains further:  https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2019/03/clnd-in-melanoma-patients-is-not.html One important note:  It is essential that the WLE and SLNB be done at the same time.  If the WLE is done with the expectation that lymph nodes will be examined later – the WLE will disrupt the flow of lymph and make finding the SLN(s) impossible.

I hope that helps.  Ask more questions as you have the need.  This site is filled with smart caring peeps.   Will keep fingers and toes crossed that further surgery will be uneventful, melanoma free, and healing will be quick!  Take good care and let us know how things go.  Celeste

Ultrasounds have been used to evaluate sentinel nodes.  This is what was found about that:  https://chaoticallypreciselifeloveandmelanoma.blogspot.com/2019/07/pre-operative-ultrasound-of-lymph-nodes.html

Almost all of us here have had to have sentinel node biopsies.  I am sure others will chime in.  c

6 weeks is reasonable wait time. Waiting will not change your stage.

Melanoma starts “shedding” cells into your lymph nodes and your blood at some point in its development. Usually these cells are killed off by the immune system (you still have immune system even with leukaemia so do not worry about it) or are unable to take hold in your body to form metastases but in some cases they can resist the immune system and can form them.

The doctors want to take out a few of your lymph nodes because finding melanoma cells in them gives them a good indication that you might have cells in other place in your body that are capable of forming metastases. The cells they find would not be the cells that went there in these 6 weeks, it is a longer process. It is very safe procedure and in your situation very very important, because if they do find cells there you have access to very effective treatments that can prevent further spread.

You are still in the middle of your diagnosis. The doctors are following a standard protocol and there aren’t good alternatives now (really. no matter what someone told you – you could discuss and you would arrive to the same conclusion – you need to have the standard tests), so that’s why they haven’t discussed things with you. If they do find cells in your lymph nodes there will be discussion about treatment (or at least you should expect one).

Best of luck!

Sorry you joined this group and I know you are in the initial information gathering stage which is always intense.  Any medical intervention or procedure is a risk (side effects, other outcomes)/reward (accurate staging and best practices moving forward based on accurate information) assessment and this assessment absolutely favors getting the sentinel lymph node biopsy.  Nothing is absolutely 100% but a biopsy and subsequent view under the microscope of the tissue is far more accurate and pretty close to 100% than non-invasive ultrasound will be in detecting tiny amounts of melanoma.

I can tell you anecdotally that my husband had his SLNB (they took 3 out along with his large melanoma) after fairly large WLE (he had very large 22 mm nodular melanoma on his shoulder).  No lymphedema afterwards, good recovery and went to work the day after.  He said his armpit pinched a bit from where they took out one of the lymph nodes.  My husband did have ultrasound imaging but not until AFTER his SNLB.  They used non-invasive ultrasound imaging every 3 months to try to detect a recurrence in the Lymph basin.   This was part of his surveillance since he was high-risk (along with other scanning), but not until after they initially checked his sentinel lymph nodes through removal and biopsy.  there are some false positives and negatives with the ultrasound (so some get unneccessary further inteventions like biopsy and some do not get a needed intervention).

You got great advice above form others and data from Celeste.  My opinion is that the benefit/risk is pretty far on the side of getting the SNLB.  I would jump all over that for the information it will provide.

Good luck!  I know it is a lot of tough choices and overwhelming information at time and you will get different information from various sources, so best bet is to go with the evidence and data.

Many hugs!  Wishing you negative results no matter what.

I had one sentinel node in my left armpit removed 2 years ago when I had a WLE for the melanoma in my upper left arm.  Yes after surgery my armpit hurt and I used an ice pack.  Then it stopped hurting and I have no swelling and no problem.  I just have a line from the scar.  I found exercise was very helpful to my recovery.  Good luck.

Sorry you have a need to be here, but this is a very caring group with a lot of information to share so you are in the right place. I see some of our experts have already chimed in and I agree, you should proceed with the WLE and SLNB so you will have a more accurate picture of what is going on. My case was a little different; they could already tell I had it in my lymph nodes at my first consult so they put me on immunotherapy and then targeted therapy first to fight it before surgery. I was diagnosed in March 2020 and finally had my surgery in June 2021. I did have a complete lymphadenectomy along with tumor removal, but again my case was a little different since they knew I had melanoma in my lymph nodes from the start. Luckily for me, it did not spread anywhere else (I was originally diagnosed as stage IV and later restaged to IIIC after a liver biopsy confirmed a spot was benign). I had to keep my drain for a whopping 27 days because I was still producing too much lymphatic fluid, but I have had no issues with lymphedema since they took it out. I am now considered NED. I know 6 weeks feels like forever, but try to stay positive!

Best of luck to you!! Sending lots of positive energy your way!

Jenn