Three Years Out All Is Well Questions on Original Pathology Report Just Received

Previously all I was given was the dermatologist’s summary of my pathology reports.  After reading and learning from the vast knowledge of those of you here, I realized I needed the actual physical pathology reports.

Originally, I was told I was stage 1a with a Breslow depth of 0.20.  Micotic rate of zero.  This was the only information that I was given, but I was concerned because I learned here that the type of biopsy done, a shave may cause problems with staging if the margins were transected.

This is the information in the original pathology report:

Diagnosis:                                     Malignant Melanoma
Breslow Thickness.                  :    0.22mm AT LEAST
Clark Level.                              :    II
Ulceration.                                :    Absent
Mitoses.                                    :    Zero per square millimeter
Tumor infiltrating Lymphocytes :    Absent
Regression.                               :    Absent
Microsatellitosis.                        :    Absent
Lymphovasular Invasion.           :    Not Identified
Margins.                                     :   Intraepidermal and dermal component transected at base of specimen.    
                                                       Intraepidermal component transected at peripheral margins.( The edge or outer                   
                                                       boundary.)

Location                                     :    Right Anterior Shoulder
Clinical Information.                   :    0.6 by 0.4 cm irregular dark brown thin papule or nevus mole
Microscopic.                               :    A neoplasm, (abnormal growth of cells can be benign), is broad, asymmetric,
                                                        and comprised of atypical melanocytes, (epidermal cells that produce pigment),
                                                        both singly and in nests throughout all levels of the epidermis and in the dermis.
                                                        Single melanocytes in the epidermis tend to confluence.
                                                        (Joining running together, denoting certain skin lesions that become merged, 
                                                        forming a patch, denoting a disease characterized by lesions that are not discrete
                                                        or distinct from the other.)                                                                                                               
                                                        Nests of melanocytes vary markedly in size and shape,  Individual melanocytes                                                
                                                        demonstrate enlarged nuclei and pleomorphism.  (Characterized by having more 
                                                        than one shape or form.)

Gross.                                        :     Received in formalin is a 0.5 x 0.5 x 1mm dark brown shave biopsy of skin.

Next is the pathology report after the Wide Level Excision, which was done with standard margins.

Diagnosis    :     Malignant Melanoma In Situ, Margins Free (Margins free of cancer are considered clean, clear or
                          negative, which is the goal of the surgery.). 
Comment    :     This melanoma has been completely excised. There is no evidence of a residual invasive component.
Site.             :     Right Anterior Shoulder
Microscopic :     Atypical melanocytes are present throughout all levels of the epidermis. In the dermis there is solar  
                          elastosis, which is an accumulation of abnormal elastin (elastic tissue) in the dermis of the skin, along
                          with thickened collagen bundles oriented parallel to the epidermis and small vessels oriented 
                          perpendicular to the epidermis.
Gross.         :     Received in formalin is a 2.5 x 2.2 x 0.9 cm tan, pink and black oriented skin ellipse.
 
                    
My conclusion from the above is the only melanoma they saw in the removed tissue was the transected portion of the peripheral margin, which is part of the epidermis.  No melanoma found in the dermis, therefore melanoma in situ instead of malignant melanoma.  Only melanoma found in the dermis was that in the originally excised skin tissue.

Comments?

This happened three years ago.  Should I seek a second opinion?

Note that I added definitions after pathology terms of art, so I could interpret their meaning with more clarity.

Susan