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    misenber
    Participant

      Last week I was told that the mole I had removed from my back was melanoma and is Clarks Level 2, less than 1 mm.  I was to havethe spot removed tomorrow, but the surgeon called and told me they have to postpone because after speaking with the pathologist, he is going to have to remove a lymph node and test it and wouldn't have the eqipment available for another week.  I am, of course distraught, but also very confused. I researched the Clarks Level 2, but can't coordinate it to the Melanoma staging, which seems to give more specific information about treatment, seriusness, prognosis, etc. I have not yet seen an oncologist, I am dealing with a general surgeon who will refer me to an oncologist after the surgery. I am 63 years old and this is my first diagnosis of melanoma. Can someone point me to a good place to get straightforward information that is easy to understand?

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    • Replies
        Janner
        Participant

          It would be a little more helpful if you had your full pathology report.  As it stands right now, this is either a stage 1a or 1b lesion.  I suspect 1b because they are planning to do a sentinel lymph node biopsy.  Your pathology report would give an exact depth And list whether or not the lesion was ulcerated and the number of mitosis.  Stage 1b has 1+ mitosis or ulceration.  Clarke level 2 is typically quite thin so it would be helpful to know the additional details.  The SLNB isn't typically done for stage 1a but different institutions have different criteria for stage 1b.

          is this surgeon well versed in doing a sentinel node biopsy?  Typically surgeons who handle breast cancer also use this technique.  You want someone who does this all the time because timing and technique may affect results.  If the results of the SNB are negative, you probably just need a good derm instead of an oncologist because surgery is the only treatment for early lesions.

            misenber
            Participant

              I received my parhology report. Although I am not sure what I am reading, I can repeat some of it:

              Tumor size: greatest dimension: 0.7 cm

              Macroscopic Satellite Nodule: None Identified

              Macroscopic Pigmentation: Present

              Histologic Type: Malignant melanoma, superficial spreading melanoma

              Maximum tumor thickness: 0.3 mm

              Anatomic Level: II (Melanoma present in but does not fill and expand papillary distance)

              Upceration: Not Identified

              Then there was the surgical report, I won't repeat the whole thing, but I was curious about the meaning of the following:

              Tumor-Infiltrating Lymphocytes: Present, brisk

              Tomor regression: not identified

              Growth Phase: radial

              Primary Tumor: pT1b Melanoma 1.0  mm or less in thickness with ulceration and/or 1 or more mitoses/mm2

              Additional Findings: Nevus remnant

              Any information that someone can provide would be most appreciated. The removal surgery is scheduled for next Wednesday.

              misenber
              Participant

                I received my parhology report. Although I am not sure what I am reading, I can repeat some of it:

                Tumor size: greatest dimension: 0.7 cm

                Macroscopic Satellite Nodule: None Identified

                Macroscopic Pigmentation: Present

                Histologic Type: Malignant melanoma, superficial spreading melanoma

                Maximum tumor thickness: 0.3 mm

                Anatomic Level: II (Melanoma present in but does not fill and expand papillary distance)

                Upceration: Not Identified

                Then there was the surgical report, I won't repeat the whole thing, but I was curious about the meaning of the following:

                Tumor-Infiltrating Lymphocytes: Present, brisk

                Tomor regression: not identified

                Growth Phase: radial

                Primary Tumor: pT1b Melanoma 1.0  mm or less in thickness with ulceration and/or 1 or more mitoses/mm2

                Additional Findings: Nevus remnant

                Any information that someone can provide would be most appreciated. The removal surgery is scheduled for next Wednesday.

                misenber
                Participant

                  I received my parhology report. Although I am not sure what I am reading, I can repeat some of it:

                  Tumor size: greatest dimension: 0.7 cm

                  Macroscopic Satellite Nodule: None Identified

                  Macroscopic Pigmentation: Present

                  Histologic Type: Malignant melanoma, superficial spreading melanoma

                  Maximum tumor thickness: 0.3 mm

                  Anatomic Level: II (Melanoma present in but does not fill and expand papillary distance)

                  Upceration: Not Identified

                  Then there was the surgical report, I won't repeat the whole thing, but I was curious about the meaning of the following:

                  Tumor-Infiltrating Lymphocytes: Present, brisk

                  Tomor regression: not identified

                  Growth Phase: radial

                  Primary Tumor: pT1b Melanoma 1.0  mm or less in thickness with ulceration and/or 1 or more mitoses/mm2

                  Additional Findings: Nevus remnant

                  Any information that someone can provide would be most appreciated. The removal surgery is scheduled for next Wednesday.

                Janner
                Participant

                  It would be a little more helpful if you had your full pathology report.  As it stands right now, this is either a stage 1a or 1b lesion.  I suspect 1b because they are planning to do a sentinel lymph node biopsy.  Your pathology report would give an exact depth And list whether or not the lesion was ulcerated and the number of mitosis.  Stage 1b has 1+ mitosis or ulceration.  Clarke level 2 is typically quite thin so it would be helpful to know the additional details.  The SLNB isn't typically done for stage 1a but different institutions have different criteria for stage 1b.

                  is this surgeon well versed in doing a sentinel node biopsy?  Typically surgeons who handle breast cancer also use this technique.  You want someone who does this all the time because timing and technique may affect results.  If the results of the SNB are negative, you probably just need a good derm instead of an oncologist because surgery is the only treatment for early lesions.

                  Janner
                  Participant

                    It would be a little more helpful if you had your full pathology report.  As it stands right now, this is either a stage 1a or 1b lesion.  I suspect 1b because they are planning to do a sentinel lymph node biopsy.  Your pathology report would give an exact depth And list whether or not the lesion was ulcerated and the number of mitosis.  Stage 1b has 1+ mitosis or ulceration.  Clarke level 2 is typically quite thin so it would be helpful to know the additional details.  The SLNB isn't typically done for stage 1a but different institutions have different criteria for stage 1b.

                    is this surgeon well versed in doing a sentinel node biopsy?  Typically surgeons who handle breast cancer also use this technique.  You want someone who does this all the time because timing and technique may affect results.  If the results of the SNB are negative, you probably just need a good derm instead of an oncologist because surgery is the only treatment for early lesions.

                    JC
                    Participant

                      Stage 1A has about a 97% 10 year survival rate.  And that includes lesions much deeper than yours (up to 1mm).  Your prognosis is pretty great. 

                        misenber
                        Participant

                          Thank you so much for replying. I am sure you can understand that finding out I had melanoma was quite a blow and then when they wanted to remove a lymph node, I was really frightened.  Thank goodness for organizations like this one.

                          misenber
                          Participant

                            Thank you so much for replying. I am sure you can understand that finding out I had melanoma was quite a blow and then when they wanted to remove a lymph node, I was really frightened.  Thank goodness for organizations like this one.

                            misenber
                            Participant

                              Thank you so much for replying. I am sure you can understand that finding out I had melanoma was quite a blow and then when they wanted to remove a lymph node, I was really frightened.  Thank goodness for organizations like this one.

                            JC
                            Participant

                              Stage 1A has about a 97% 10 year survival rate.  And that includes lesions much deeper than yours (up to 1mm).  Your prognosis is pretty great. 

                              JC
                              Participant

                                Stage 1A has about a 97% 10 year survival rate.  And that includes lesions much deeper than yours (up to 1mm).  Your prognosis is pretty great. 

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