Can In Situ be properly diagnoses with shave biopsy

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    • August 18, 2014 at 1:14 am
    Nicole35
    Participant

      I am new here so Id like to say hello! I was diagnosed with Melanoma In Situ on 8/6/14, had my WLE on 8/13.. Now I am waiting for those results. In the mean time I have been reading my original path report and noticed some things of concern. First off, my mole, which was flat, small mis shaped, was taken with a shave biopsy and that came back in situ, can In situ truly be diangnoses with just a shave? Or is it more of AT LEAST In Situ? Also path report says things like with in Epidermis there are nested and single melanocytes growing in a lentiginous and confluent growth pattern, the lesion closely approaches a lateral margin and there is pagetoid scatter of melanocytes to higher levels of the dermis.  I hate this waiting game, and am concerned that with a shave biopsy in situ is just the only depth it could be staged at.  im aware of how dangerous Melanoma can be, my aunt had a WLE with no further treatment and 10 years later out of no where had stage 4 melanoma in her lungs. I want to see a melanoma specialist to be on the safe side, but any and all info anyone here could give is very much appreciated. Melanoma is a beast and we are all fighters. Thank you so much! And God bless!

      ps. I also have several dysplastic nevi

       

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        • August 18, 2014 at 2:53 am
        Janner
        Participant

          Yes, in situ can be diagnosed with a shave biopsy.  Most shaves do go deeper than the epidermis and have no problems diagnosing in situ.  BTW, it's always more helpful if you can include the ENTIRE path report.  However, since the "dermis" is mentioned in the description, that means the shave was deep enough to see the dermis even though the deep margin is not mentioned.  In situ is totally confined to the epidermis meaning it hasn't invaded the dermis.  So it appears that in situ is the proper diagnosis and the shave biopsy did not bisect the lesion.  However, you will still need to have the WLE (wide local excision) to get larger margins all around – standard protocol.

            • August 18, 2014 at 2:57 am
            Janner
            Participant

              Oops, sorry, saw that you already had the WLE.  Chances are, the WLE will find no additional melanoma.   If you have to have melanoma, in situ is where you want to be. 

              • August 18, 2014 at 4:35 am
              Nicole35
              Participant

                Thank you for your response! I feel like I can breathe a little better now. Haha! If i have any more questions about Path reports I will be sure to include all of it. Thanks again!! 

                • August 18, 2014 at 4:35 am
                Nicole35
                Participant

                  Thank you for your response! I feel like I can breathe a little better now. Haha! If i have any more questions about Path reports I will be sure to include all of it. Thanks again!! 

                  • August 18, 2014 at 4:35 am
                  Nicole35
                  Participant

                    Thank you for your response! I feel like I can breathe a little better now. Haha! If i have any more questions about Path reports I will be sure to include all of it. Thanks again!! 

                    • August 18, 2014 at 2:57 am
                    Janner
                    Participant

                      Oops, sorry, saw that you already had the WLE.  Chances are, the WLE will find no additional melanoma.   If you have to have melanoma, in situ is where you want to be. 

                      • August 18, 2014 at 2:57 am
                      Janner
                      Participant

                        Oops, sorry, saw that you already had the WLE.  Chances are, the WLE will find no additional melanoma.   If you have to have melanoma, in situ is where you want to be. 

                      • August 18, 2014 at 2:53 am
                      Janner
                      Participant

                        Yes, in situ can be diagnosed with a shave biopsy.  Most shaves do go deeper than the epidermis and have no problems diagnosing in situ.  BTW, it's always more helpful if you can include the ENTIRE path report.  However, since the "dermis" is mentioned in the description, that means the shave was deep enough to see the dermis even though the deep margin is not mentioned.  In situ is totally confined to the epidermis meaning it hasn't invaded the dermis.  So it appears that in situ is the proper diagnosis and the shave biopsy did not bisect the lesion.  However, you will still need to have the WLE (wide local excision) to get larger margins all around – standard protocol.

                        • August 18, 2014 at 2:53 am
                        Janner
                        Participant

                          Yes, in situ can be diagnosed with a shave biopsy.  Most shaves do go deeper than the epidermis and have no problems diagnosing in situ.  BTW, it's always more helpful if you can include the ENTIRE path report.  However, since the "dermis" is mentioned in the description, that means the shave was deep enough to see the dermis even though the deep margin is not mentioned.  In situ is totally confined to the epidermis meaning it hasn't invaded the dermis.  So it appears that in situ is the proper diagnosis and the shave biopsy did not bisect the lesion.  However, you will still need to have the WLE (wide local excision) to get larger margins all around – standard protocol.

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