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July 10, 2013 at 2:14 pm #21438SmallFrward1Participant
I am not currently diagnosed so I hope it’s appropriate for me to post here, I have once in the past as I need advice from someone that can help. I recently received 2 shave biopsies at the derm that were done by a PA-C that sees me. Both lesions came back with mild cytologic and architectural atypia that extended to deep margins. On my next visit (yesterday), she proceeded to do a deeper shave into them to get clear margins and said that excisional biopsy was completely unnecessary. If an excisional biopsy was not necessary, then why shave a deep hole into these areas and retest them? I feel that she did it to her own benefit and to save her own time. Does anyone have experience with this or gotten two shaves on one lesion to remove more tissue before?
Another question I have is about a mole she removed from my right leg, I remember having for at lest 6-7 years w/o noticeable change and don’t know exactly how long it had been there before. It had “eccentric hyperpigmentation” which google shows many melanomas have. She agreed to take it off but explained it as “just looks like some scarring and it’s probably nothing” and did another shave biopsy. I included the picture, maybe someone can shed some light onto what this could be or if they have ever had a mole like this. I am very scared it’s been a melanoma sitting on my leg for at least 6 years. Any help you guys can give would really calm me down and at least shed some light onto the situation b/c I feel mistreated by the PA-C. (Having trouble with the photo, is uploading possible?)July 10, 2013 at 2:19 pm #61765cohanjaParticipant
With regard to the mild atypia, there really isn’t a standard of care on how to handle these. Some doctors always want clear margins for any atypia, mine doesn’t even re-excise if it’s mild with margins involved.
Also, shave probably isn’t the best unless it’s deep shave (saucerization) to get the whole lesion.July 10, 2013 at 4:49 pm #61766Catherine PooleKeymaster
I would switch providers. I’m not sure why she would do a second shave biopsy. Deep shaves are the only acceptable biopsies next to excisional. Sounds like some potentially unnecessary work being done, but best to get another opinion.July 30, 2013 at 4:21 pm #61767gigisboobooParticipant My concerns are why this forum is very, very important. In 2007, in the midst of trying to find a missing teenager I received “the call” from my doctor. The next day I had surgery with a lemon size incision on my left lower leg. Follow up has been full body checks every 6 months. 2009 a Basal Cell removed from right shoulder. Two weeks ago a mole removed at my request was in Situ and surgery was completed two weeks ago. The stitches will be removed in three days. THIS IS ALL THE INFORMATION I HAVE, WHAT SHOULD I BE ASKING? I live in Birmingham but my doctor is not at U.A.B. Thank you for any help you can provide.
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