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December 6, 2013 at 8:31 pm #21702
I was diagnosed with early stage melanoma in 2011, had a WLE and the margins were clear. My oncologist did a PET/CT scan and all was fine. I’ve been regularly going for full body scans by my dermatologist the past two years and all has been clear until now. I have many moles on my body and I noticed one which was small and brown turned into what looked like a pimple. I called my dermatologist and made an appointment for the following week. During that time the “pimple” went from red and back to brown. My dermatologist removed the mole and sent it in to the lab. I see the dermatologist next week but I called today to see if the results were in from my lab and the nurse practitioner told me the mole had “atypical cells” in it but the margins were clear and that I shouldn’t be concerned. I asked to have the dermatologist call me back as I’m, of course, concerned there were abnormal cells. I asked the nurse if there was any mention of melanoma and she said there was no mention of melanoma. I’m waiting for the doctor to call me back but in the interim, is this something that sounds like I should worry about? Additionally, my worry now that I’ve had a second mole that was mildly problematic is whether or not it is a matter of time before melanoma shows up again. Finally, ought I ask my dermatologist to start removing any mole exhibiting the usual warning signs (asymmetry, irregular borders, etc.) as I have plenty which appear that way but my dermatologist feels aren’t worth removing. Any insight is appreciated. Thank you.December 6, 2013 at 9:18 pm #63156cohanjaParticipant Atypia can be mild, moderate or severe. You want to know the severity of the atypia. And if atypical cells extended to the margins of the biopsy specimen.
There is no standard protocol for atypical nevi deemed mild or moderate but there is a recommendation for severely atypical nevi to have 5mm margins – just like melanoma in situ. Atypical nevi have a higher likelihood to turn into melanoma and if there are cells left behind, that is the worry. Were your margins clear? It may be ok to just watch the scar area and if there is any sign of pigment regrowth, you could have it excised then. I’d ask for copy of your pathology report (always a good idea) and discuss this more in depth with your doctor. In the end, because of the real lack of formal guidelines (other than severely atypical), this is about what makes you feel comfortable.December 7, 2013 at 1:34 pm #63157Catherine PooleKeymaster
I guess I would like to weigh in here a bit. First of all, some folks have lots of atypical or dysplastic nevi (moles) My husband is one of them. Yes, they should have frequent skin exams and photography, but you can’t predict which mole if any will become a melanoma. So wholesale removal is not productive and is in fact not a good idea. Now if a biopsy comes back with atypical cells (this is different from having an atypical dysplastic mole) then sometimes a wide excision may be advised. But for the most part this isn’t a danger sign.December 8, 2013 at 2:38 pm #63158 Thank you for the insightful reply, Catherine. The nurse told me the margins on the biopsy were clear which I understand is a good sign. I’ve asked the doc to call me to address the following and let me know if I’m worrying unnecessarily as it consumes my day…the bummer is that I feel like it is inevitable another melanoma will occur because I had 1 already and now another biopsy where there were abnormal cells. Makes me feel like there must be something already brewing that hasn’t shown up yet.December 9, 2013 at 8:34 pm #63159Webbie73Participant Lefty, the best advice I can give you is to relax! You said early stage, what stage? Going to an oncologist and having a pet/ct seems a little drastic for an early stage melanoma.
Listen to your dermatologist, after all they are the professionals.December 9, 2013 at 10:29 pm #63160
I switched dermatologists because my first dermatologist did a poor job with my biopsy, resulting in an inability to obtain a full report on the details of my lesion. Accordingly, the depth of my melanoma read “at least 0.4mm” but the exact depth is unknown because the sample contained crush artifact. Accordingly, I don’t know if “at least 0.4mm” means the true depth was 0.42 or 1.2. Accordingly, I’m vigilant about staying on top of this. Additionally, when there is uncertainty regarding true depth my oncologist suggested the PET/CT to establish a base line of whether the melanoma had metastasized since the true depth of the lesion is unknown.
Webbie, I appreciate you taking time to respond but merely suggesting I merely “relax” is, respectfully, of no value.December 10, 2013 at 12:00 am #63161Webbie73Participant
Lefty, I am sorry you feel my advice is of little value. I believe constant worry is not good. Most people here have gone through the initial shock of being diagnosed with melanoma. With time the constant fear, worry levels out. Vigilance is the best weapon. Early melanoma has an excellent survival rate.January 11, 2014 at 5:11 am #63162SleepyKittyParticipant I’m so frustrated. I’ve typed my reply 3 times but before I finish my phone crashes
Anyway I just wanted to let you know you are not alone. I’m new here and my first thread I started is about this exact same fear.
It is only around 6 months since my successful WLE, but I just had to have 3 biopsies, one of which came back as atypical. Luckily for me I had a great nurse who called and she was able to give a lot of info. Since mine was “mildly atypical” and since the margins were clear, the biopsy itself was considered all the treatment needed. If it happens again but with moderate or severe label then they’ll want to do something else.
But even though she gave me all the info about atypical does not equal melanoma, I still worry. I had no worries with the actual malignant melanoma because it all happened so fast that I didnt have time to worry. But this time I know more and I wonder if that us why I’m suddenly worried.
Was your original site easily visible? How about your new biopsy sites visible? My melanoma was on my back (and so was this new atypical finding). But I also had a biopsy site near my elbow. I’m currious if seeing it now is why the fear won’t completely go away. My scars heal well but take forever so I’m stuck with this reminder for a while.
I don’t have much encouragement to help you relax, but since other have made it through this I have to believe we will too.January 11, 2014 at 1:56 pm #63163Catherine PooleKeymaster
It is true that stress lowers your immune system, so there are ways to work with this stress. Meditation is one, exercise (aerobic 3x a week is good) breathing deeply when you are stressed, getting a massage, and in general stopping the thought stream that may be negative. You do sound like if you find anything it will be very early and removed. Photography is the single best way to follow your moles and skin. Invest in that and try to move on and enjoy each moment of life as it is much shorter than we all realize.
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