This is all I know as of today, my first appt with a Surgical Oncologist will be on the 5th of Dec. I was told by the person making the appt that because of the mitotic rate >3 that in addition to the WLE I would undergo a SNB… I have found a lot of mixed information reguarding whether or not a SNB is indicated in a Stage 1b patient…(Asumeing that is where I am.) She had told me that the standared practice includes a SNB anytime the M.R. is >1mm2… I know I will know more on the 5th and I'm trying not to flip-out but, if anyone has more info on what I could be in store for I'd appriciate it very much.
They don't usually do an SLN unless the lesion is at least >0.76 mm, sometimes >1.0 mm because the chance of spread or recurrence is so low it is not worth the cost to do an SLN. I don't know how the mitotic index factors into the decision (MI of 3 isn't so bad; I've seen several cases where it was >10). Hopefully, others here will be able to comment on how the MI impacts the SLN decision.
I will say, however, that if it was me I would ALWAYS want to have an SLN biopsy. I would be frustrated if I could not get one even if my diagnosis was only "melanoma in situ". It's a farily simple procedure and it would help to put my mind at ease. I guess the choice will be up to you. What would make you feel more comfortable in the long run– have an SLN biopsy or no?
Regardless of your decision, you're only Stage 1 and your lesion is thin, so the odds are strongly in your favor that you will never see melanoma again. Good for you!
They don't usually do an SLN unless the lesion is at least >0.76 mm, sometimes >1.0 mm because the chance of spread or recurrence is so low it is not worth the cost to do an SLN. I don't know how the mitotic index factors into the decision (MI of 3 isn't so bad; I've seen several cases where it was >10). Hopefully, others here will be able to comment on how the MI impacts the SLN decision.
I will say, however, that if it was me I would ALWAYS want to have an SLN biopsy. I would be frustrated if I could not get one even if my diagnosis was only "melanoma in situ". It's a farily simple procedure and it would help to put my mind at ease. I guess the choice will be up to you. What would make you feel more comfortable in the long run– have an SLN biopsy or no?
Regardless of your decision, you're only Stage 1 and your lesion is thin, so the odds are strongly in your favor that you will never see melanoma again. Good for you!
They don't usually do an SLN unless the lesion is at least >0.76 mm, sometimes >1.0 mm because the chance of spread or recurrence is so low it is not worth the cost to do an SLN. I don't know how the mitotic index factors into the decision (MI of 3 isn't so bad; I've seen several cases where it was >10). Hopefully, others here will be able to comment on how the MI impacts the SLN decision.
I will say, however, that if it was me I would ALWAYS want to have an SLN biopsy. I would be frustrated if I could not get one even if my diagnosis was only "melanoma in situ". It's a farily simple procedure and it would help to put my mind at ease. I guess the choice will be up to you. What would make you feel more comfortable in the long run– have an SLN biopsy or no?
Regardless of your decision, you're only Stage 1 and your lesion is thin, so the odds are strongly in your favor that you will never see melanoma again. Good for you!
Actually, POW is wrong, the 3mm mitotic is a very important reason to do the SLNB, it means the cells are dividing and the spread possibility is greater. You might be smart to get a second opinion on the pathology to make sure about the mitotic. If it were me, I would get the SLNB if it turns out to be 3mm.
Actually, POW is wrong, the 3mm mitotic is a very important reason to do the SLNB, it means the cells are dividing and the spread possibility is greater. You might be smart to get a second opinion on the pathology to make sure about the mitotic. If it were me, I would get the SLNB if it turns out to be 3mm.
Actually, POW is wrong, the 3mm mitotic is a very important reason to do the SLNB, it means the cells are dividing and the spread possibility is greater. You might be smart to get a second opinion on the pathology to make sure about the mitotic. If it were me, I would get the SLNB if it turns out to be 3mm.
Breslow depth is still more important than mitosis number in terms of prognosis. Even with 3 mitotic figutes, the chances of spread are very small wth a lesion of less than 0.76 mm thick. You can do SNLB but I am almost certain that it will be negative, I wish the staging system would not lump all thin (< 1.00 mm melanomas) into one category baased on mitosis because the difference is huge between 0.9 mm and 0.5 mm depth.
Breslow depth is still more important than mitosis number in terms of prognosis. Even with 3 mitotic figutes, the chances of spread are very small wth a lesion of less than 0.76 mm thick. You can do SNLB but I am almost certain that it will be negative, I wish the staging system would not lump all thin (< 1.00 mm melanomas) into one category baased on mitosis because the difference is huge between 0.9 mm and 0.5 mm depth.
Breslow depth is still more important than mitosis number in terms of prognosis. Even with 3 mitotic figutes, the chances of spread are very small wth a lesion of less than 0.76 mm thick. You can do SNLB but I am almost certain that it will be negative, I wish the staging system would not lump all thin (< 1.00 mm melanomas) into one category baased on mitosis because the difference is huge between 0.9 mm and 0.5 mm depth.
That’s not what the experts say and could be why some low risk lesions turn out to be a future issue. Second opinion on the pathology is a good idea since this is a thin lesion otherwise.
That’s not what the experts say and could be why some low risk lesions turn out to be a future issue. Second opinion on the pathology is a good idea since this is a thin lesion otherwise.
That’s not what the experts say and could be why some low risk lesions turn out to be a future issue. Second opinion on the pathology is a good idea since this is a thin lesion otherwise.
I didn't see any paper in PubMed that analysed the recurrence rate in different Breslow groups in less than 1.00 mm. My melanoma specialist said that he would not ooffer SNLB to someone with Breslow 0.5 mm with mitosis > 1.
I didn't see any paper in PubMed that analysed the recurrence rate in different Breslow groups in less than 1.00 mm. My melanoma specialist said that he would not ooffer SNLB to someone with Breslow 0.5 mm with mitosis > 1.
I didn't see any paper in PubMed that analysed the recurrence rate in different Breslow groups in less than 1.00 mm. My melanoma specialist said that he would not ooffer SNLB to someone with Breslow 0.5 mm with mitosis > 1.
Thank you all for the replies… Surgery on the 11th for the wide excision and SLNB… Fingers crossed!
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