Biopsy Interpretation

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  • Post
    • August 18, 2016 at 6:42 pm
    julia80211
    Participant

      Hello-

      I've seen some others post their biospy results so I'm hoping that someone can take a look at mine too.  

       

      A little background: A friend of mine passed away from Melanoma last fall.  She asked all her friends to get skin checks, so I did.  I had one mole that had changed but nothing that seemed concerning as it had always been skin color.  Then part of it develped pigment.  Then the pigment formed a dark line in the mole, so I made an appointment.  She drilled how important the "E" is when looking at your moles.  The PCP said "It's probably nothing" but referred me.  The derm thought it was nothing but took the biopsy to put my mind at ease.  Everything came back fine in March.  

      Once the biopsy area healed a tiny dark spot showed up and grew rather quickly from a tiny dot to a 3mm spot in the matter of a few weeks.  I was in for something else and the derm saw it and asked so I recounted what happened.  At that point they decided to take a punch biopsy.  

      I got a call last Monday.  The derm said that the biospy came back with "severe atypia" and she said the pathologists couldn't decide if it was atypical or melanoma.  So I have a excision scheduled for Sept. 2nd.  From reading other path reports on here, I don't seem to have some of the key measurements though. 🙁 

      I just picked up a copy of the report today to try to put my mind at ease.  The whole "maybe it is, maybe it isn't" made me nervous.  

      On the tissue exam part it reads "erthematous papule x 6 hours, reactive erthema vs erthema multiforme vs bullous arthropodB- hyperpigmented 3mm macule in site of previous shave biopsy for nevus, recurrent nevus vs atypical nevus vs melanoma."  

      It was reviewed by 2 pathologists.  The first one said "recurrent junctional nevus with architectural disorder and severe cytologic atypica, surgical margin free of involvement."  Sounds good, I think?   The report says thsi person is a pathologist but doesn't specify dermapathologist. Second pathologist (who is specified as a dermapathologist) says: "hyperpitmented 3mm macule in site of previous shave biopsy for nevus, recurrent nevus vs atypical nevus vs melanoma."  

      Normally, I wouldn't worry but given how quickly the spot grew at the point of the shave biopsy is making me a little nervous.  Any thoughts? 

       

      Thank you!

    Viewing 2 reply threads
    • Replies
        • August 20, 2016 at 9:19 pm
        debwray
        Participant

          Hi Julia,

          I don't fully understand your report – but think it is good that you have the September removal scheduled- better safe than sorry. This might be worth a read .. 

          http://archderm.jamanetwork.com/article.aspx?articleid=1774053

          Basically it seems to say that at times a differential diagnosis is difficult- and especially so where a melanoma might have spontaneously regressed.

          You should be able to ask your doc for an explanation- but I think in the end they are likely to say that there is an amount of uncertainty – whichis small but their advice is that you should act just in case – as that means if it is something unwelcome then it has been caught at the earliest possible time…better to remove a few "normal " moles early  than leave a possible early melanoma to develop-  

          Sorry not a terribly informative reply- as I don't have the skills to interrpret the results fully- but I would be more than happy to go with a precautionary approach if I was walking in your shoes.

          All the best  

          Deb

          • August 20, 2016 at 9:19 pm
          debwray
          Participant

            Hi Julia,

            I don't fully understand your report – but think it is good that you have the September removal scheduled- better safe than sorry. This might be worth a read .. 

            http://archderm.jamanetwork.com/article.aspx?articleid=1774053

            Basically it seems to say that at times a differential diagnosis is difficult- and especially so where a melanoma might have spontaneously regressed.

            You should be able to ask your doc for an explanation- but I think in the end they are likely to say that there is an amount of uncertainty – whichis small but their advice is that you should act just in case – as that means if it is something unwelcome then it has been caught at the earliest possible time…better to remove a few "normal " moles early  than leave a possible early melanoma to develop-  

            Sorry not a terribly informative reply- as I don't have the skills to interrpret the results fully- but I would be more than happy to go with a precautionary approach if I was walking in your shoes.

            All the best  

            Deb

            • August 20, 2016 at 9:19 pm
            debwray
            Participant

              Hi Julia,

              I don't fully understand your report – but think it is good that you have the September removal scheduled- better safe than sorry. This might be worth a read .. 

              http://archderm.jamanetwork.com/article.aspx?articleid=1774053

              Basically it seems to say that at times a differential diagnosis is difficult- and especially so where a melanoma might have spontaneously regressed.

              You should be able to ask your doc for an explanation- but I think in the end they are likely to say that there is an amount of uncertainty – whichis small but their advice is that you should act just in case – as that means if it is something unwelcome then it has been caught at the earliest possible time…better to remove a few "normal " moles early  than leave a possible early melanoma to develop-  

              Sorry not a terribly informative reply- as I don't have the skills to interrpret the results fully- but I would be more than happy to go with a precautionary approach if I was walking in your shoes.

              All the best  

              Deb

                • August 21, 2016 at 9:40 pm
                julia80211
                Participant

                  Hi Deb-

                  Thank you for responding!  I don't understand what the report says either.  lol  

                  I found this link which seems to agree: http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia.  

                  I'm definitely all for the excision coming up.  I think it will also give more info and possibly finalize a diagnosis from what I can tell.  

                  One of the big things that I'm struggling with is what to do about sun exposure.  Does having had a severly atypical/insitu melanoma mean you should follow the guidelines for avoiding sun exposure?  I can't find any recommended guidelines.  Right now I work a lot of the summer outside from 11a-2p so it's a concern for me. 

                  • August 22, 2016 at 9:23 pm
                  debwray
                  Participant

                    Re sun exposure-to reduce the risk of melanoma  the guidance is to limit exposure- and use sunscreen /sun protective clothing when out in the sunshine. – avoid tanning beds etc.  Try the link from this site-

                    https://www.melanoma.org/understand-melanoma/preventing-melanoma

                    I think it is good advice to follow to reduce your risk of skin cancer anyway…

                    Best of luck- Deb

                     

                     

                    • August 22, 2016 at 9:23 pm
                    debwray
                    Participant

                      Re sun exposure-to reduce the risk of melanoma  the guidance is to limit exposure- and use sunscreen /sun protective clothing when out in the sunshine. – avoid tanning beds etc.  Try the link from this site-

                      https://www.melanoma.org/understand-melanoma/preventing-melanoma

                      I think it is good advice to follow to reduce your risk of skin cancer anyway…

                      Best of luck- Deb

                       

                       

                      • August 22, 2016 at 9:23 pm
                      debwray
                      Participant

                        Re sun exposure-to reduce the risk of melanoma  the guidance is to limit exposure- and use sunscreen /sun protective clothing when out in the sunshine. – avoid tanning beds etc.  Try the link from this site-

                        https://www.melanoma.org/understand-melanoma/preventing-melanoma

                        I think it is good advice to follow to reduce your risk of skin cancer anyway…

                        Best of luck- Deb

                         

                         

                        • August 21, 2016 at 9:40 pm
                        julia80211
                        Participant

                          Hi Deb-

                          Thank you for responding!  I don't understand what the report says either.  lol  

                          I found this link which seems to agree: http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia.  

                          I'm definitely all for the excision coming up.  I think it will also give more info and possibly finalize a diagnosis from what I can tell.  

                          One of the big things that I'm struggling with is what to do about sun exposure.  Does having had a severly atypical/insitu melanoma mean you should follow the guidelines for avoiding sun exposure?  I can't find any recommended guidelines.  Right now I work a lot of the summer outside from 11a-2p so it's a concern for me. 

                          • August 21, 2016 at 9:40 pm
                          julia80211
                          Participant

                            Hi Deb-

                            Thank you for responding!  I don't understand what the report says either.  lol  

                            I found this link which seems to agree: http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia.  

                            I'm definitely all for the excision coming up.  I think it will also give more info and possibly finalize a diagnosis from what I can tell.  

                            One of the big things that I'm struggling with is what to do about sun exposure.  Does having had a severly atypical/insitu melanoma mean you should follow the guidelines for avoiding sun exposure?  I can't find any recommended guidelines.  Right now I work a lot of the summer outside from 11a-2p so it's a concern for me. 

                            • September 3, 2016 at 12:42 am
                            julia80211
                            Participant

                              I had my excision today.  It's a lot bigger than I thought it would be!  They said 5mm margins.  I didn't understand it would be 5mm from the edge of the punch biopsy scar.  It ended up being kind of an "S" shape vs the football shape and is 5.5cm long.  They said I'd hear about the biopsy in 7 business days.  

                              • September 3, 2016 at 12:42 am
                              julia80211
                              Participant

                                I had my excision today.  It's a lot bigger than I thought it would be!  They said 5mm margins.  I didn't understand it would be 5mm from the edge of the punch biopsy scar.  It ended up being kind of an "S" shape vs the football shape and is 5.5cm long.  They said I'd hear about the biopsy in 7 business days.  

                                • September 3, 2016 at 12:42 am
                                julia80211
                                Participant

                                  I had my excision today.  It's a lot bigger than I thought it would be!  They said 5mm margins.  I didn't understand it would be 5mm from the edge of the punch biopsy scar.  It ended up being kind of an "S" shape vs the football shape and is 5.5cm long.  They said I'd hear about the biopsy in 7 business days.  

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