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- August 16, 2018 at 12:59 am
Hi Anonymous,
I was diagnosed with Spitzoid melanoma Breslow 1.0mm, high mitotic rate, non-ulcerated, Clark Level IV. T1b. My doctors (surgeon, dermatologist) were not considering neither discussing SLNB, I did have the feeling that it should be done and after seeking advise from a melanoma expert, I decided to go for it. SLNB came back negative.
As for for your specific case, I do not think the SLNB would have been necessary. For me it was a very personal decision and against the opinon of my doctors; for what I can see my case had worst prognosis than yours though, with risk factors involved (clark level, gender, age, mitotic rate).
This was useful for me:
https://www.skincancer.org/publications/the-melanoma-letter/2018-vol-36-no-1/ajcc-staging-system
"guidelines state that for patients with T1b (<0.8 mm with ulceration or 0.8-1.0 mm with or without ulceration) melanomas, SLNB may be considered and discussed with the patient.22,26"
So unless you had ulceration (for what you said I dont think so), SLNB would not be advised. Furthermore, after WLE has been done, SLNB may be more difficult (less accurate) to perform.
Again, I am not as well informed as other users in the forum. But you seem to be on thin side of melanoma with a very good prognosis.
That being said. I am lost with the Spitzoid myself. I asked about DecisionX factor and was told that due to the type (spitzoid) which as you said is quite rare, it may not be useful in my case, but I was not able to find a lot of info on it. My melanoma was in an area which is not very exposed to the sun and do not have any close cases in my family.
Spitzoid or not, your prognosis at that Breslow level is very good and you should not worry too much (I know is easier said than done, believe me).
Cheers!
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- November 27, 2018 at 10:15 pm
Thanks Both,
It is very useful to listen to your opinions, my biggest fear is that doctors here (living in Asia) are not too used to deal with melanoma. They are good doctors, but do not see thin melanoma that often.
This morning just noticed I have one more swollen node in my neck (again felt pain). Weird.
Anybody knows if melanoma can spreed to non regional locations so fast – primary location on the back part of my right waist with SLN located in my right groin – ? I had a clear PET-CT scan on April and negative SLNB in June.
Anyhow, is time to get it checked somehow and probably do more research on Stages III and IV (have been avoiding that and focusing on going on with my life)
Again, appreciate a lot all your help. The informationon contained this forum has been crucial for me so far.
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- April 30, 2018 at 12:27 pm
OP here,
Thanks a lot for the info Celeste. I do appreciate all the help. Have been reading your blog before and has been an extremely helpful source of resources, had not found the post you are sharing here though, so thanks for that.
Did not make my decision yet, looking for a second opinion from a doctor back home. Is difficult being "lost in translation" when dealing with something like this.
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