Amelanotic Lentigno Malignant Melanoma–Need Help with Biopsy

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  • Post
    • February 14, 2017 at 8:27 pm
    lisaha
    Participant

      Hi All,

      I have studied my shave biopsy report and done a lot of reading of journals online as well as here on this group.

      My diagnosis is "mostly in situ" with "rare, few cells/focal invasion" into the dermis.  Breslow=.15 and Clark II.  

      I am undergoing a MOhs in a couple of days.

      My concern with my biopsy, which is basically otherwise negative (no ulceration, etc… 0 mitotic rate "seen") —

      The Deep Margins are not clear–there is malignant melanoma to 0.1mm of deep margin and it also has melanoma in situ present on it.

      Doesn't this pretty clearly indicate that my Breslow's level as it is currently is probably going to be upstaged during the Mohs???

      Need help–thanks!!

      Sincerely,

      Lisa

       

    Viewing 5 reply threads
    • Replies
        • February 14, 2017 at 9:42 pm
        youngann
        Participant

          Hello Lisa, sorry that you have joined our club. A second excision on the same lesion will not change your Breslow depth even though it wasn't all removed. The docs don't add the depths of two excisions together.

          Good luck,

          Ann

            • February 14, 2017 at 11:35 pm
            lisaha
            Participant

              Thank you, Anne.  

              • February 14, 2017 at 11:35 pm
              lisaha
              Participant

                Thank you, Anne.  

                • February 14, 2017 at 11:35 pm
                lisaha
                Participant

                  Thank you, Anne.  

                • February 14, 2017 at 9:42 pm
                youngann
                Participant

                  Hello Lisa, sorry that you have joined our club. A second excision on the same lesion will not change your Breslow depth even though it wasn't all removed. The docs don't add the depths of two excisions together.

                  Good luck,

                  Ann

                  • February 14, 2017 at 9:42 pm
                  youngann
                  Participant

                    Hello Lisa, sorry that you have joined our club. A second excision on the same lesion will not change your Breslow depth even though it wasn't all removed. The docs don't add the depths of two excisions together.

                    Good luck,

                    Ann

                    • February 14, 2017 at 10:13 pm
                    Janner
                    Participant

                      Deep margin is close — but melanoma in situ is not the deep margin so that just needs wide margins.  Your depth will not change – Mohs is not the type of excision that could ever provide another depth.   Most melanoma is re-excised via wide location excision (WLE) where they just take a big chunk of skin.  Mohs removes smaller sections of skin to minimize the amount of tissue removed.  Mohs isn't typically used for melanoma unless it is in a tissue sensitive area.

                        • February 14, 2017 at 11:38 pm
                        lisaha
                        Participant

                          Thank you, Janner.  It's on my cheek.  I'm just confused about it.  I thought it was all relatively fine except that I had to get some of my face excised, but then I got really freaked out about the deep margin.  

                          • February 14, 2017 at 11:38 pm
                          lisaha
                          Participant

                            Thank you, Janner.  It's on my cheek.  I'm just confused about it.  I thought it was all relatively fine except that I had to get some of my face excised, but then I got really freaked out about the deep margin.  

                            • February 14, 2017 at 11:38 pm
                            lisaha
                            Participant

                              Thank you, Janner.  It's on my cheek.  I'm just confused about it.  I thought it was all relatively fine except that I had to get some of my face excised, but then I got really freaked out about the deep margin.  

                            • February 14, 2017 at 10:13 pm
                            Janner
                            Participant

                              Deep margin is close — but melanoma in situ is not the deep margin so that just needs wide margins.  Your depth will not change – Mohs is not the type of excision that could ever provide another depth.   Most melanoma is re-excised via wide location excision (WLE) where they just take a big chunk of skin.  Mohs removes smaller sections of skin to minimize the amount of tissue removed.  Mohs isn't typically used for melanoma unless it is in a tissue sensitive area.

                              • February 14, 2017 at 10:13 pm
                              Janner
                              Participant

                                Deep margin is close — but melanoma in situ is not the deep margin so that just needs wide margins.  Your depth will not change – Mohs is not the type of excision that could ever provide another depth.   Most melanoma is re-excised via wide location excision (WLE) where they just take a big chunk of skin.  Mohs removes smaller sections of skin to minimize the amount of tissue removed.  Mohs isn't typically used for melanoma unless it is in a tissue sensitive area.

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