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what does ‘partial focal regression’ mean in a melanoma pathology report?
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what does ‘partial focal regression’ mean in a melanoma pathology report?

› Forums › General Melanoma Community › what does ‘partial focal regression’ mean in a melanoma pathology report?

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    • May 30, 2012 at 10:22 am
    JC
    Participant

      what does 'partial focal regression' mean melanoma pathology report?  is it an independent prognostic indicator?  why would one report say this, and another opinion says "tumor regression: absent" ?

      what does 'partial focal regression' mean melanoma pathology report?  is it an independent prognostic indicator?  why would one report say this, and another opinion says "tumor regression: absent" ?

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    • Replies
        • June 2, 2012 at 6:39 am
        AlisonC
        Participant
          Well partial means the regression was only in part (obviously) and focal means only in a specific or small area (as opposed to along the whole margin). It’s not uncommon…apparently…for melanoma to have some regression, but it’s not really a prognostic indicator sorry. If there was evidence of a lot of regression (so, not just partial and not just focal) then it can mean that the Mel they removed is no longer at the max depth it reached, which can complicate staging, but if yours is only partial and focal it just means some eagle-eyed white cells got going on one part, but not all, of your primary.

          I’ve found big differences between different labs on path reports. It maybe that one pathologist had keener eyes than another (and so spotted some regression that another person didn’t see) or it may be that the regressed area was so small (so “focal”) that one pathologist didn’t think it constituted evidence of regression at all and so dismissed it. Hard to know, although frustrating.

          What matters FAR more in a path report is the depth (and it sounds like you will have gotten a fairly good reading on that if regression wasn’t a significant factor), mitotic rate, lymph/vascular invasion and clear margins.

          Good luck……

          AlisonC
          Stage IIIB
          NED since 2001

            • June 2, 2012 at 11:47 am
            JC
            Participant

              Thanks, AlisonC. The depth has been pretty consistent across opinions; anywhere from 0.2 to 0.3 to 0.33mm. Lymph/vascular invasion, margins, ulceration. . all pretty consistently negative. Mitotic rate was also something inconsistent. 2 reports found no mitotic rate, and 2 other opinions identified one dermal mitotic figure and put it at <1/mm2. So, I don't know if that changes stage from 1A to 1B, or how much that increases my risk (0 mitosis versus <1).

              • June 2, 2012 at 11:47 am
              JC
              Participant

                Thanks, AlisonC. The depth has been pretty consistent across opinions; anywhere from 0.2 to 0.3 to 0.33mm. Lymph/vascular invasion, margins, ulceration. . all pretty consistently negative. Mitotic rate was also something inconsistent. 2 reports found no mitotic rate, and 2 other opinions identified one dermal mitotic figure and put it at <1/mm2. So, I don't know if that changes stage from 1A to 1B, or how much that increases my risk (0 mitosis versus <1).

                • June 2, 2012 at 11:47 am
                JC
                Participant

                  Thanks, AlisonC. The depth has been pretty consistent across opinions; anywhere from 0.2 to 0.3 to 0.33mm. Lymph/vascular invasion, margins, ulceration. . all pretty consistently negative. Mitotic rate was also something inconsistent. 2 reports found no mitotic rate, and 2 other opinions identified one dermal mitotic figure and put it at <1/mm2. So, I don't know if that changes stage from 1A to 1B, or how much that increases my risk (0 mitosis versus <1).

                • June 2, 2012 at 6:39 am
                AlisonC
                Participant
                  Well partial means the regression was only in part (obviously) and focal means only in a specific or small area (as opposed to along the whole margin). It’s not uncommon…apparently…for melanoma to have some regression, but it’s not really a prognostic indicator sorry. If there was evidence of a lot of regression (so, not just partial and not just focal) then it can mean that the Mel they removed is no longer at the max depth it reached, which can complicate staging, but if yours is only partial and focal it just means some eagle-eyed white cells got going on one part, but not all, of your primary.

                  I’ve found big differences between different labs on path reports. It maybe that one pathologist had keener eyes than another (and so spotted some regression that another person didn’t see) or it may be that the regressed area was so small (so “focal”) that one pathologist didn’t think it constituted evidence of regression at all and so dismissed it. Hard to know, although frustrating.

                  What matters FAR more in a path report is the depth (and it sounds like you will have gotten a fairly good reading on that if regression wasn’t a significant factor), mitotic rate, lymph/vascular invasion and clear margins.

                  Good luck……

                  AlisonC
                  Stage IIIB
                  NED since 2001

                  • June 2, 2012 at 6:39 am
                  AlisonC
                  Participant
                    Well partial means the regression was only in part (obviously) and focal means only in a specific or small area (as opposed to along the whole margin). It’s not uncommon…apparently…for melanoma to have some regression, but it’s not really a prognostic indicator sorry. If there was evidence of a lot of regression (so, not just partial and not just focal) then it can mean that the Mel they removed is no longer at the max depth it reached, which can complicate staging, but if yours is only partial and focal it just means some eagle-eyed white cells got going on one part, but not all, of your primary.

                    I’ve found big differences between different labs on path reports. It maybe that one pathologist had keener eyes than another (and so spotted some regression that another person didn’t see) or it may be that the regressed area was so small (so “focal”) that one pathologist didn’t think it constituted evidence of regression at all and so dismissed it. Hard to know, although frustrating.

                    What matters FAR more in a path report is the depth (and it sounds like you will have gotten a fairly good reading on that if regression wasn’t a significant factor), mitotic rate, lymph/vascular invasion and clear margins.

                    Good luck……

                    AlisonC
                    Stage IIIB
                    NED since 2001

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