AMH or Melanoma In SItu? Clear Margins?

› Forums › General Melanoma Community › AMH or Melanoma In SItu? Clear Margins?

  • Post
    • May 19, 2015 at 1:54 am
    raeds
    Participant

      Hi all –

      I know I am very fortunate to not have a melanoma diagnosis, but I do have many atypical moles and have had 3 AMH (Atypical Melanocytic Hyperplasia) removed. I have read on line that some docs don't like to call a a melanoma in situ, so they say AMH instead. I DID speak to the pathologist (pretty reknowned – at Scripps in San Diego) and he said I did not have melanoma in-situ. 

       

      Here is my concern: the derm who removed the first 2 AMHs 7 years ago only took 3 mm margins on one, and 4mm margins on the other. I am freaked that the margins weren't large enough. The pathologist had recommended 3-5 mm, and if I had been aware, I would have insisted on 5 mm. Fast forward 7 years, I have a 5 year old and a 21 month old and have just had another possibly atypical mole removed, and I am now obessessing about the old AMHs.

       

      What is the liklihood of recurrence? Does recurrence happen at the site? After 7.5 years, am I in the clear on these? 

       

      Please help. My anxiety is peaking. 

       

      Thank you.

    Viewing 2 reply threads
    • Replies
        • May 19, 2015 at 11:22 pm
        Janner
        Participant

          Margins are to remove any stray cells which are most likely to occur with an actual melanoma diagnosis.  (The deeper the lesion, the more likely cells have traveled).  If you haven't had any pigment regrowth in 7 years, consider it removed!  There is nothing left to obsess about.  Margins are precautionary and an exact value isn't a guarantee of anything.  Even with wider margins, you should always watch for pigment regrowth.  Since you've had none, it's pretty obvious that all cells were removed.  Honestly, I wouldn't give either of the lesions another thought!

            • May 20, 2015 at 2:04 am
            raeds
            Participant

              Thank you very much, Janner. Definitely no pigmentation in the scars. There is a tiny light brown freckle on the outskirts of one of the scars, but unrelated, I believe.

              I did have another AMH in 2011. My new doc knew how nervous I was and took a 5 mm margin and original punch had cleared it anyway (same with the first 2). There are two very faint brown spots on the outer edge of this big scar, but the doc says it is benign, and not re-pigmentation (she is very well versed with a dermatascope). Do I need to push to have those brown spots biopsied?

              I did have pigmentation in another scar, so doc removed the whole thing (an atypical mole) and the pigment was not a nevus, and unrelated on biopsy.

              So, any advice on the brown spots stated above by my big scar?

              Thank you for your expert advice.

              • May 20, 2015 at 3:05 am
              Janner
              Participant

                I have pigment in many scars, some melanoma scars and others not.  Has the pigmentation grown?  In 7 years, it would have continued to grow if it were of any concern.  Again, I'd say these are long gone and not of any concern.  People who have lots of moles and freckles are more likely to have pigment.  CHANGE and continuing to grow are what I worry about and I've been at this for 23 years now since my first melanoma.

                • January 13, 2016 at 6:50 pm
                raeds
                Participant

                  Hello again Janner –

                   

                  Sorry to bother you, but I am spinning again after the removal of a moderately atypical tiny (2mm) mole that I insisted upon – feeling like I can't trust my docs. Margins clear.

                   

                  I had current doc and her colleague both look at my AMH scars. My regular doc said scars look great. (both checked with dermatascope). New doc checked thoroughly and said that the one with 4 mm margin clearance has a tiny very light (I can't see it with naked eye) freckle that is being pulled into the scar but it is its own entity. She said she is certain there is no melanoma here and she said she rarely if ever says certain.

                   

                  My carcinophobia (yes, it has a name) is brutal at times, and the lack of 5 mm margins is playing with my head again.

                   

                  8 years since removals. If I was going to have recurrence or metastisize, would that have already happened? Any thoughts on the freckle?

                  • January 13, 2016 at 6:50 pm
                  raeds
                  Participant

                    Hello again Janner –

                     

                    Sorry to bother you, but I am spinning again after the removal of a moderately atypical tiny (2mm) mole that I insisted upon – feeling like I can't trust my docs. Margins clear.

                     

                    I had current doc and her colleague both look at my AMH scars. My regular doc said scars look great. (both checked with dermatascope). New doc checked thoroughly and said that the one with 4 mm margin clearance has a tiny very light (I can't see it with naked eye) freckle that is being pulled into the scar but it is its own entity. She said she is certain there is no melanoma here and she said she rarely if ever says certain.

                     

                    My carcinophobia (yes, it has a name) is brutal at times, and the lack of 5 mm margins is playing with my head again.

                     

                    8 years since removals. If I was going to have recurrence or metastisize, would that have already happened? Any thoughts on the freckle?

                    • January 13, 2016 at 6:50 pm
                    raeds
                    Participant

                      Hello again Janner –

                       

                      Sorry to bother you, but I am spinning again after the removal of a moderately atypical tiny (2mm) mole that I insisted upon – feeling like I can't trust my docs. Margins clear.

                       

                      I had current doc and her colleague both look at my AMH scars. My regular doc said scars look great. (both checked with dermatascope). New doc checked thoroughly and said that the one with 4 mm margin clearance has a tiny very light (I can't see it with naked eye) freckle that is being pulled into the scar but it is its own entity. She said she is certain there is no melanoma here and she said she rarely if ever says certain.

                       

                      My carcinophobia (yes, it has a name) is brutal at times, and the lack of 5 mm margins is playing with my head again.

                       

                      8 years since removals. If I was going to have recurrence or metastisize, would that have already happened? Any thoughts on the freckle?

                      • May 20, 2015 at 3:05 am
                      Janner
                      Participant

                        I have pigment in many scars, some melanoma scars and others not.  Has the pigmentation grown?  In 7 years, it would have continued to grow if it were of any concern.  Again, I'd say these are long gone and not of any concern.  People who have lots of moles and freckles are more likely to have pigment.  CHANGE and continuing to grow are what I worry about and I've been at this for 23 years now since my first melanoma.

                        • May 20, 2015 at 3:05 am
                        Janner
                        Participant

                          I have pigment in many scars, some melanoma scars and others not.  Has the pigmentation grown?  In 7 years, it would have continued to grow if it were of any concern.  Again, I'd say these are long gone and not of any concern.  People who have lots of moles and freckles are more likely to have pigment.  CHANGE and continuing to grow are what I worry about and I've been at this for 23 years now since my first melanoma.

                          • May 20, 2015 at 2:04 am
                          raeds
                          Participant

                            Thank you very much, Janner. Definitely no pigmentation in the scars. There is a tiny light brown freckle on the outskirts of one of the scars, but unrelated, I believe.

                            I did have another AMH in 2011. My new doc knew how nervous I was and took a 5 mm margin and original punch had cleared it anyway (same with the first 2). There are two very faint brown spots on the outer edge of this big scar, but the doc says it is benign, and not re-pigmentation (she is very well versed with a dermatascope). Do I need to push to have those brown spots biopsied?

                            I did have pigmentation in another scar, so doc removed the whole thing (an atypical mole) and the pigment was not a nevus, and unrelated on biopsy.

                            So, any advice on the brown spots stated above by my big scar?

                            Thank you for your expert advice.

                            • May 20, 2015 at 2:04 am
                            raeds
                            Participant

                              Thank you very much, Janner. Definitely no pigmentation in the scars. There is a tiny light brown freckle on the outskirts of one of the scars, but unrelated, I believe.

                              I did have another AMH in 2011. My new doc knew how nervous I was and took a 5 mm margin and original punch had cleared it anyway (same with the first 2). There are two very faint brown spots on the outer edge of this big scar, but the doc says it is benign, and not re-pigmentation (she is very well versed with a dermatascope). Do I need to push to have those brown spots biopsied?

                              I did have pigmentation in another scar, so doc removed the whole thing (an atypical mole) and the pigment was not a nevus, and unrelated on biopsy.

                              So, any advice on the brown spots stated above by my big scar?

                              Thank you for your expert advice.

                            • May 19, 2015 at 11:22 pm
                            Janner
                            Participant

                              Margins are to remove any stray cells which are most likely to occur with an actual melanoma diagnosis.  (The deeper the lesion, the more likely cells have traveled).  If you haven't had any pigment regrowth in 7 years, consider it removed!  There is nothing left to obsess about.  Margins are precautionary and an exact value isn't a guarantee of anything.  Even with wider margins, you should always watch for pigment regrowth.  Since you've had none, it's pretty obvious that all cells were removed.  Honestly, I wouldn't give either of the lesions another thought!

                              • May 19, 2015 at 11:22 pm
                              Janner
                              Participant

                                Margins are to remove any stray cells which are most likely to occur with an actual melanoma diagnosis.  (The deeper the lesion, the more likely cells have traveled).  If you haven't had any pigment regrowth in 7 years, consider it removed!  There is nothing left to obsess about.  Margins are precautionary and an exact value isn't a guarantee of anything.  Even with wider margins, you should always watch for pigment regrowth.  Since you've had none, it's pretty obvious that all cells were removed.  Honestly, I wouldn't give either of the lesions another thought!

                            Viewing 2 reply threads

                            Tagged: 

                            • You must be logged in to reply to this topic.
                            About the MRF Patient Forum

                            The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                            The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.