Home Forums Melanoma: Newly Diagnosed – Stages I & II Dad just diagnosed with nodular melanoma-questions

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  • #21136
    megan722
    Participant

    Hello. My dad (age 59) was diagnosed with nodular melanoma last week. He had what he thought was a skin tag on his neck that he first noticed approx 10 months ago. He went to his physician who said it was a skin tag and not to worry about it. He noticed it growing recently and went back to the doctor who then removed it. It came back with the following path report:

    Nodular melanoma

    Breslow depth: 3.1 mm

    Clarks Level: IV

    Ulceration: None

    Mitosis Rate: 3

    Margins: Clear

    He met with the surgeon today and will have a SNB and WLE on 4/8. My questions are regarding the mitosis and ulceration. From everything I’ve read, those are 2 of the biggest predictors with melanoma and nodular in particular. The depth is intermediate but the fact that it is NOT ulcerated is good right? I’ve been researching the mitosis rate and have found that the closer it is to 0-1 the better but that 1-4 is considered growing and over 4 (and particularly over 6) is active growth. Would a mitosis of 3 that is non-ulcerated be considered in his favor at this point? We are really praying for no spread to the lymph nodes. Any thoughts on the path report? Thanks so much!

    Megan

    #59812
    Catherine Poole
    Keymaster

    Megan,

    Your father is fortunate to have you looking out for him. He probably needs that as it can be so overwhelming. At this juncture what is most important is how the SLNB turns out. Originally, the depth or Breslow was most important, and the mitotic value is according to some, an important prognostic indicator. The concern with nodular is that is tends to skip the usual growth phases and is faster in its growth. Make sure his pathology is being reviewed by a good dermatopathologist, you may want to send for another opinion. And treatment in a good melanoma center is very important too. Let us know how things are going.

    #59813
    megan722
    Participant

    Thanks Catherine. We’ve been told multiple times that it’s a very good sign that it was not ulcerated-what are your thoughts on this? We live in Southern CA in the Los Angeles area so lots of options for treatment. I’m a nursing supervisor at UCLA (although in abdominal organ transplant not oncology) so am hoping he could be seen there if needed although we are also close to City of Hope in Duarte and The Angeles Center (I think that’s what its called). Any opinions on any of those options? Thanks again!

    Megan

    #59814
    chas66
    Participant

    Megan, It’s a very good sign that it was not ulcerated. Ulcerated raises the stakes. For example, my breslow was 4.5 and it was nodular. My SLNB showed clear. So, I’m stage 2B. If my mole was ulcerated, I would be Stage 2C and although at this time that might not sound like much, there is difference in survival rates between the two.

    His mitosis is fairly low, that’s good.

    Keep in mind that the #’s might change a little based on a second set of eyes looking at the original slides.

    Good luck.

    #59815
    megan722
    Participant

    chas66 wrote:

    Megan, It’s a very good sign that it was not ulcerated. Ulcerated raises the stakes. For example, my breslow was 4.5 and it was nodular. My SLNB showed clear. So, I’m stage 2B. If my mole was ulcerated, I would be Stage 2C and although at this time that might not sound like much, there is difference in survival rates between the two.

    His mitosis is fairly low, that’s good.

    Keep in mind that the #’s might change a little based on a second set of eyes looking at the original slides.

    Good luck.

    He already had 2 pathologists look at it and both agreed with the findings so I’m thinking that’s good. Fingers crossed that the SLNB comes back normal!

    #59816
    Catherine Poole
    Keymaster

    UCLA is tops. I would recommend you go there! Dr. Ribas or his associates are great. I would focus on his upcoming pathology rather than his past. Let us know how things turn out.

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