Understanding pathology report.

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    • October 26, 2018 at 3:18 am
    Jhynes
    Participant
      Had a nevus malignant melanoma removed breslow .2mm . Then had a WLE the report says negative for residual malignant melanoma , margins negative for melanoma . It also says ” centrally located on the skin surface is a sutures area that measures appx 2.0cm on length , and upto 0.2cm in thickness and comes to within 0.7cm of the closest short axis resection margin” my surgeon then said he is happy with what he took but would like to take another 0.7mm . But its upto me if I want this done or not. Does this make any sense?
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        • October 26, 2018 at 6:33 am
        Janner
        Participant

          Generally, a stage 1 lesion has 1cm margins in all directions.  While your WLE has 1cm margins on the length, the depth is only 2mm, not 1 cm.  And the width is also not 10mm.  So by taking more, your doctor is following normal guidelines for a stage 1 lesion.  Personally, I'd have it done.  To date, the most successful treatment for melanoma is surgical removal at an early stage.  Unless the scar is going to be disfiguring, I would err on the side of caution and go with the recommended margins – especially the depth.  Most WLEs take all the skin below a lesion down to the muscle fascia and I'm puzzled why he took so little the first time.  You have to do what makes you comfortable but the doctor is following an established protocol trying to obtain wide margins.

            • October 26, 2018 at 3:28 pm
            Jhynes
            Participant
              This is a mostly in situ with some focus of small early invasion . And does the original biopsy count towards the margins? It was an excisional biopsy piece was 1.4cm × 0.8cm × 0.2cm .
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