Another Abnormal Mole but not Cancer

[Icegurl470]

23 year old female diagnosed 6 months ago with stage 1b Melanoma on the top right side of back. Since then, I’ve had 2 other moles removed and tested. The first one was normal, but the second one came back “abnormal”. The doc said it wasn’t cancer, but the pathology lab put a note on my report that recommended excision?? He said he would normally just keep an eye on it. He wouldn’t normally go back and remove healthy tissue, but the abnormal cells extended all the way to the edge of the tissue samples and, given my history, it wasn’t a bad idea to go back and make sure he got clean borders. He said it wouldn’t be anything like the WLE I had done on my back, he would just have to go a little wider.

I know its nothing serious but I cant help but be disappointed. I was told both the moles I had removed looked normal and they only removed them to ease my worries. The fact that one of them was already heading towards the path of cancer only deepens my worries. Deep down I was hoping I was only being paranoid and my all my other moles would be normal. I don’t want to spend the rest of my life having bits and pieces cut off, but I fear it will be the only way to end my worries.

[cohanja]

I think there are degrees of abnormal. . mild, moderate, severe. Even though I’ve had melanoma, even when a mildly abnormal lesion is removed and extends to the edges, they don’t go back and re-excise anything. Probably only would do that for moderate to severe abnormal.

[wpatterson4]

Quote:

I don’t want to spend the rest of my life having bits and pieces cut off, but I fear it will be the only way to end my worries.

You eventually get past this stage. For one thing, you start to see that the smaller moles aren’t getting any uglier as time goes by. The bigger moles are the ones that most resemble melanoma visually, so you’re naturally going to be concerned about them. However, they’re the ones getting removed, so you have less of them to bug you after each visit to your dermatologist.

The first year is really rough, emotionally speaking. If you weren’t a worrier, you probably wouldn’t be on this forum. I hope you achieve peace of mind. God knows we all want it.

[Lisa P]

Hi, there. First, I’m sorry for what you’re going through. Second, I can speak to some of your concerns based on my experience. If you look at some of my past posts, it will give my history. Three mels in two years – one was insitu, one was .23mm, and the other was .5mm. In addition to those, I have had too many biopsies of questionable moles to count at this point, with almost all coming back as moderately abnormal. Once biopsied, my skin oncologist does a 3 cm WLE (melanomas call for a 5 cm, i believe– could someone correct me if I’m off on the mm versus cm part?). Anyway, I look like I had an intimate dance with an angry bear because of all the scars. As early as last month my doc said she talked to a bunch of pathologists and some other colleagues and, based on those discussions, has decided to stop biopsying all but a) new moles that have appeared since I took my grid body photographs two years ago; and b) moles that have visibly changed or are evolving. Her reasoning is that I am clearly making dysplastic/abnormal moles and that if we biopsied every spot on my body, a good 90 % would likely be abnormal. According to her, there is no scientific proof that abnormaly dysplastic nevi will, in fact, morph into melanoma. They may be more likely to do so than normal cells, but I could live to be one hundred without any of them actually turning. Hence, the decision to keep a close eye and stop cutting. Because of my situation, I go in and am seen more than anyone else that I’ve heard from on this site, but it’s what makes me comfortable so… If I can get a few years of time from my last last melanoma diagnosis (February 2012), I may loosen up and go from monthly visits to quarterly. We shall see. In the meantime, please hang in there. Also, it never hurts to get a second set of eyes on you if you’re emotionally upset and worried. Any doc worth their salt will not begrudge you doing that. Please keep us posted and let us know how you’re doing. Take good care, Lisa

[Laurie]

Icegurl470 – You have come to a good place here. Catherine and her sources are wonderful. I can understand your disappointment, concern and anxiety – you are young and never expected a melanoma diagnosis. It almost sounds as if your pathology lab wants to hedge its bet with the note about further excision. You may want to have another opinion on this most recent biopsy.

My derm also tells me that most moles that come back moderately abnormal should not need to excised any further.

I am very similar to Lisa P. Fair skinned and blue-eyed; and lots of moles & freckles. Three melanoma in-situs in 3+ years; many suspicious looking moles removed with biopsy results from benign to ‘ varying degrees of abnormal’; and I am back to quarterly visits. I actually had my quarterly exam today and came out with NO biopsies. The most important thing that my derm has told me (because of all my moles) is to be very aware of anything “NEW” and to watch the evolution of my moles – if they are changing/evolving (aka the “E” in the ABCDEs of skin), they need to be looked at AND to be sure to have a dermatologist examine my skin regularly.

Please take care of yourself and let us know how you make out. If you have questions, concerns, need to vent, need support or undestanding – We are all here for you!

Good Wishes!

[krissy424]

Lisa P posted :

Quote:

moles that have visibly changed or are evolving. Her reasoning is that I am clearly making dysplastic/abnormal moles and that if we biopsied every spot on my body, a good 90 % would likely be abnormal.

This is exactly what my derm told me. I have many odd looking moles.

I’ve only had the one bx of the mole removed on 6/15/12

SSM 1A breslow .55 clark ll radial growth phase

[AngelaM]

The fact that you have had a melanoma means that you are more likely than the person in the street to have some abnormal/ atypical moles. That’s unfortunately how it is.

My first dysplastic mole was found when I was about 9 yrs old. Since then I’ve had so many dysplastic moles removed that I have completely lost count. Probably in the range of 50 or 60. I’ve also had 3 melanomas, all caught reasonably early. I am surprised when a mole is removed and it doesn’t come back dysplastic, because I expect them all to! If your worry is about surviving this, then it sounds like you are on top of the disease already. If your worry is scarring and endless biopsies, then I think you should take the advice of wpatterson4. This person is correct – you will get past the stage of having many biopsies. If they remove anything dodgy now then only new or evolving moles will need to be removed later. By the way, all of my melanomas arose ‘de novo’. I know this because I have baseline photographs taken over many years of my entire body. You might want to take some photos of yourself and compare back to them every few months or so. That has helped me.

[cohanja]

If someone is going to develop another melanoma, is it usually within a certain timeframe of the first one?

[AngelaM]

Cohanja, for me that question has been at the top of my mind for quite some time.

I had 3 melanomas in the space of 2 years. 1 right before my pregnancy (in-situ) and 2 within a year of the birth (both SSM 1A). I wanted to have another baby this year but my doctors REFUSE to support another pregancy, saying that pregnancy can (in their opinion) influence melanoma. They told me to wait for 2 yrs from my last melanoma diagnosis before another pregnancy. The thing that worries me is that I’m not getting any younger and neither are my eggs, and I really think my son needs a sibling. I am 13 months out from my 3rd melanoma at this point. If I get another melanoma now it sets me back another 2 yrs! So I asked them that very question, and they said that in their experience subsequent melanomas are normally found within about 2 years of the first melanoma. I have also done many searches on the internet, and it does seem that this is the case. The problem is that this research is subject to bias because the longer people live (since their mel was caught early), the more time there is for more melanomas to develop. Some people get their second melanoma 10 years after their first. My doctors have told me, however, that in their experience, most people that get multiple primaries do seem to reach a point where their skin settles and they stop getting them. I REALLY hope that this is true.

[cohanja]

Thanks. I’m about a year and a half out from my diagnosis. I feel like just when I may let my guard down is when something would occur. Also, I wonder if that is 2 years from diagnosis or 2 years from when the melanoma actually began. Because the melanoma could have been there for months or even years before diagnosis.

[AngelaM]

Exactly. The two years is only measured from the time of diagnosis, and your melanoma could have been there for a few months already. That is why no one actually knows, and the key is to just keep having yourself checked, literally forever!

[wpatterson4]

cohanja wrote:

Thanks. I’m about a year and a half out from my diagnosis. I feel like just when I may let my guard down is when something would occur.

I thought I was the only one who felt this dread. It’s as if fate would curse you with another one, or with metastasis, just for having a little peace of mind.

[Icegurl470]

Thanks for the advice everyone. I’m also fair with blue eyes, my sister actually has ocular albinism and although she doesn’t have cutaneous albinism she’s extremely pale with very pale blonde hair. Skin cancer runs in my family. Fortunately I don’t have too many moles… The two that I had removed were the only large and irregular looking ones. I thought once they were gone I’d feel better, but now I find myself worrying about my other moles. I’ve only been to the derma once and he didn’t recommend any biopsies. My melanoma surgeon recommended I see a derma every three months for the first couple years, but my derma didn’t schedule me for a follow-up for another 6 months. He also only looked at the moles I was “concerned” about and he didn’t take pictures or anything, so I find it hard to believe that in 6 months he’s going to be able to tell if they’ve changed, and I’d like somebodies opinion other than my own. When I was first diagnosed I sought treatment from one of the top cancer centers in the country. They have a Melanoma Center and I’m going to see one of their dermas in January. I’m hoping they will have some better insight/more advanced techniques that will help put my mind at ease. I may try to see them twice a year between my other regular derma apts, that way I’ll be getting checked every three months like my surgeon said. I am a bit of a control freak. I’ve always been very driven, and my health is no different. I have a great job, and I’m finishing my degree part-time. In a few years I hope to buy a house, get married and have family, so I don’t want this condition to get out of control and ruin my plans.

I have a few really dark freckles/small moles on my legs. One of them is quite dark and has kinda jagged edges, but it’s tiny. I thought it was a weird hair follicle at first, but it hasn’t gone away. My legs haven’t seen the light of day since my diagnosis, so I would think If they were just freckles they would start to fade. But, melanoma is usually larger right? The one on my back started in a large irregular birth mark. Melanoma doesn’t start out as a tiny black freckle does it? Is there any type of skin cancer that’s starts out as tiny black speckles on the legs or arms? Thanks.

[cohanja]

I know they talk about the ABCDE signs of melanoma, but they all certainly don’t have to follow that. Mine did not really stand out to me nor to my derm.

[Icegurl470]

AngelaM, I’ve also heard that pregnancy can trigger melanoma or speed up the growth of the cancer. It’s extremely disheartening that your doctor advised you not to have another pregnancy until two years out of your diagnosis. Like I said I have a five year plan and I would be very disappointed if I got married, finished college and couldn’t start a family. I totally understand your concerns. I tend to err on the side of caution, but I think if it were me I would go ahead with my pregnancy. Like you said you may end up waiting and then find another malignancy before the two years is up and have to wait another two years! As long as your on top of you skin checks I don’t see why you should have to wait.

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