Specialist or regular derm for WLE?

Hi MeganD,

According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116825/, dermatologists are the primary physicians managing patients with thin melanomas. I gather you are not being referred for a sentinel lymph node (SLN) biopsy as nodal involvement is rare for thin (≤1 mm) primary melanoma.

Its fine to ask your dermatologist how often they treat thin melanomas.  A consideration is location of the lesion. If it is on the face, for example, a plastic surgeon specializing in melanoma would be worth asking about.

Best wishes!

Cindy

my derm basically told me he doesn’t do surgery if it reaches the dermis.

 

you want to get all the melanoma, beyond the margins.

 

my wle required anesthesia and I used an oncological surgeon who understood surgery and cancer.

 

if you have a choice, why not go with the best available?

It depends on where it is in the body, how wide of margins they’re going for , and if you need lymph node biopsies. For thickness <0.8 mm lymph node biopsies are not recommended. The margins are recommended per tumor thickness and can be anywhere from 0.5 cm to 2 cm. My melanoma was on my scalp, needed 1 cm margins, and needed neck lymph node biopsies so I was referred to a head/neck surgeon. If I have another melanoma and it’s thin and on a body part like stomach or leg I would be fine having a dermatologist do it. If you’re being referred out that can take longer to get an appointment, have the consultation, etc so it may make more sense to stay with the derm you’re established with.

Go to a specialist! I had my wle 6 months ago for a stage 1a, very low risk lesion… and it has recurred in the scar, meaning they didn’t remove enough! I now have to have another wle and an slnb. I was just getting to the point where I was ok with living with this diagnosis and not being scared all the time. My primary was on my back, .4mm.