4th Severely Atypical Mole…Need advice!

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  • Post
    • August 8, 2016 at 4:56 pm
    Mddonnelly
    Participant

      Hello!

       

      I am a 32 year old women who got a skin check last year for the first time.  My derm biopsied 3 moles.  One was mildly atypical and two were moderately atypical.  He re-excised the moderately atypcal moles.

      After those excisions were complete, he biopsied two more.  They both came back severely atypical, with one noted on the path report as a "possible evolving melanoma in situ".  They were all re-excised with clear margins.

      The mildly atypical mole from my original biopsy grew back.  They re-excised that one too.

      Last week was my 6 month skin check.  He biopsied three more moles, and two came back severely atypical and one came back moderate.  He plans to re-excise them all.  He warned me that the one on my foot will be hard to heal, and may require antibiotics.

      That makes 8 excisions all together, with half being severely atypical.

      My questions;

      1) Should I be going to a dermatologist who specializes in Melanoma or pigmented lesions?  I like my guy but this seems like a situation that maybe calls for someone who isn't doing Botox half the time.

      2) Is he being too aggressive?  Do I really need all of these surgeries?  It feels overwhelming.  Do you think the moderately atypical moles really need to be excised?

      3) How worried should I be about the possibility of Melanoma?  Because I'm starting to worry.  It feels like every time I go in we biopsy or remove another atypcal mole. 

      Any advice or words of encouragment very much appreciated!

      Meghan

    Viewing 5 reply threads
    • Replies
        • August 8, 2016 at 7:32 pm
        keepthefaith11
        Participant
          Hi Meghan, someone else will be able to respond to your question much better than me but I just wanted to say that just today I got a call about a biopsy I did last week. They took one mole and it ended up being moderately atypical. I am going in Wednesday to take more margins and they said they always do this with moderately atypical moles.
          She said that there was one spot on the mole that did not have clear margins.

          So it seems at least a place I go to, taking out more margins is the norm for moderately atypical situations. I am glad that they are doing this since my father has stage 4 melanoma and I am definitely afraid now that I am going to end up with melanoma as well. Better safe than sorry. I don’t care if I will end up with a bunch of scars. I just want anything suspicious completely off.

          Annie

          • August 8, 2016 at 7:32 pm
          keepthefaith11
          Participant
            Hi Meghan, someone else will be able to respond to your question much better than me but I just wanted to say that just today I got a call about a biopsy I did last week. They took one mole and it ended up being moderately atypical. I am going in Wednesday to take more margins and they said they always do this with moderately atypical moles.
            She said that there was one spot on the mole that did not have clear margins.

            So it seems at least a place I go to, taking out more margins is the norm for moderately atypical situations. I am glad that they are doing this since my father has stage 4 melanoma and I am definitely afraid now that I am going to end up with melanoma as well. Better safe than sorry. I don’t care if I will end up with a bunch of scars. I just want anything suspicious completely off.

            Annie

            • August 8, 2016 at 7:32 pm
            keepthefaith11
            Participant
              Hi Meghan, someone else will be able to respond to your question much better than me but I just wanted to say that just today I got a call about a biopsy I did last week. They took one mole and it ended up being moderately atypical. I am going in Wednesday to take more margins and they said they always do this with moderately atypical moles.
              She said that there was one spot on the mole that did not have clear margins.

              So it seems at least a place I go to, taking out more margins is the norm for moderately atypical situations. I am glad that they are doing this since my father has stage 4 melanoma and I am definitely afraid now that I am going to end up with melanoma as well. Better safe than sorry. I don’t care if I will end up with a bunch of scars. I just want anything suspicious completely off.

              Annie

              • August 10, 2016 at 8:16 am
              stars
              Participant

                Hi

                I'm all for second opinions. I think if out of eight excisions, he has spotted four atypical moles with one possible melanoma, he is actually doing a reasonable job at identifying suspect moles. I don't think you need a different doctor, but for peace of mind go to a different derm next time. I did this and ended up moving (actually doctor to doctor, not derm to derm). The second doctor just fits my life better / has my confidence.  Short answer: I don't think he's done a bad job, but don't feel bad trying out someone else. Also, if it's your first skin check then you probably have a bit of a 'backlog' of dodgy freckles/moles that has now been cleared. Yes, all the excisions are horrible… but it's 32 years worth, you might not have any issues for a very long time or indeed at all. You could also consider requesting that your 'maybe an in situe' pathology be re-checked by some kind of specialist dermatopathologist to get a more definitive diagnosis. But that doesn't change anything, really, in my view – you'll still be someone who needs to get regular-ish skin checks by the sounds.

                Stars

                • August 10, 2016 at 8:16 am
                stars
                Participant

                  Hi

                  I'm all for second opinions. I think if out of eight excisions, he has spotted four atypical moles with one possible melanoma, he is actually doing a reasonable job at identifying suspect moles. I don't think you need a different doctor, but for peace of mind go to a different derm next time. I did this and ended up moving (actually doctor to doctor, not derm to derm). The second doctor just fits my life better / has my confidence.  Short answer: I don't think he's done a bad job, but don't feel bad trying out someone else. Also, if it's your first skin check then you probably have a bit of a 'backlog' of dodgy freckles/moles that has now been cleared. Yes, all the excisions are horrible… but it's 32 years worth, you might not have any issues for a very long time or indeed at all. You could also consider requesting that your 'maybe an in situe' pathology be re-checked by some kind of specialist dermatopathologist to get a more definitive diagnosis. But that doesn't change anything, really, in my view – you'll still be someone who needs to get regular-ish skin checks by the sounds.

                  Stars

                  • August 10, 2016 at 8:16 am
                  stars
                  Participant

                    Hi

                    I'm all for second opinions. I think if out of eight excisions, he has spotted four atypical moles with one possible melanoma, he is actually doing a reasonable job at identifying suspect moles. I don't think you need a different doctor, but for peace of mind go to a different derm next time. I did this and ended up moving (actually doctor to doctor, not derm to derm). The second doctor just fits my life better / has my confidence.  Short answer: I don't think he's done a bad job, but don't feel bad trying out someone else. Also, if it's your first skin check then you probably have a bit of a 'backlog' of dodgy freckles/moles that has now been cleared. Yes, all the excisions are horrible… but it's 32 years worth, you might not have any issues for a very long time or indeed at all. You could also consider requesting that your 'maybe an in situe' pathology be re-checked by some kind of specialist dermatopathologist to get a more definitive diagnosis. But that doesn't change anything, really, in my view – you'll still be someone who needs to get regular-ish skin checks by the sounds.

                    Stars

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