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February 22, 2013 at 8:08 pm #21043
Hi all looking for any additional info on my path report as follows
Superficial spreading malignant melanoma
Clarke level 3
Ulceration not identified
Mitotic rate 12 mm2
Lymphatic/perineural/angui/invasion not identified
Tumor infiltrating lymphocytes brisk
Deep margin not involved
Peripheral margin involved
Meeting with surgical oncologist next wed for consult needs wide excision located on upper abdomen
As well as melanoma in duty on lower back and 2 dysplastic Nevis with dysplasia lower back and mid back
Could use some help ok what all this means
Any questions I should be asking. Derm said possible lymp biopsy.February 22, 2013 at 10:16 pm #59310chas66Participant
An important question is, was the skin broken or bleeding above the mole before you had the biopsy. That’s what’s called the ulceration. Let us know. A high mitotic rate (which is what you have-how fast the cancer cells divide) with the low Breslow (depth of the cancer) is something to be concerned with.February 23, 2013 at 12:01 am #59311Catherine PooleKeymaster We usually suggest you get another opinion on your pathology by an expert. Where was yours done? Your melanoma is fairly shallow depth at .7 but the regression and mitotic rate can boost your risk. Are they suggesting you have a sentinel node biopsy? If the second opinion from an expert is the same, I would think of opting for a sentinel node biopsy. You can read more about that on this website (and be sure to look above in at the Newly Diagnosed area and Melanoma Terms. For more on the SLNb: BLUE . I had a .76 depth melanoma with 1 mitotic and regression too, 24 years ago. Try not to worry and make sure you educate yourself and see the best expert if possible. http://www.melanomainternational.org/melanoma_info/sentinel_node_biopsy.htmlFebruary 23, 2013 at 12:08 am #59312 No it did not bleed at the time that I ever noticed. And it looks like it was not reported in the pathology or it was and its listed as stated above
As far as the slb I am meeting with a oncology next week so far my Derm said it was small chance of doing one. Just wanted some advise from others who have been where I am now. So far the pathology came out of a lab in Ohio. My other question is there any worry over the 2 spots that they found. And would guess I’d they biopsy the others they mapped there is probably more but they are small in comparison to the one we are talking about.
Thanks for the reply and kind wordsFebruary 23, 2013 at 3:44 am #59313krissy424Participant
I would have the lymph node biopsy with the wide excision based on regression and the mitotic rate. Breslow.7 is a good number.
Mine was Breslow .55 and Clark ll. Keep in touch.February 23, 2013 at 11:10 am #59314cohanjaParticipant
“Regression present” I’d ask if it was extensive regression (> 75%) or partial/focal regression.February 23, 2013 at 1:00 pm #59315Catherine PooleKeymaster Be sure to get a second opinion on the pathology. A high mitotic rate doesn’t often go hand in hand with a shallow lesion of .7. Your slides can easily be sent to an expert at a teaching institute. Or you can try: http://www.drmihm.comand have an opinion from Dr. Mihm, a Harvard expert. You want to be sure before you proceed with a SLNB that it is necessary. Regression can be a weakly negative factor. Mitotic factor means cells were dividing and reproducing at a certain rate.February 23, 2013 at 3:23 pm #59316chas66Participant That’s good that the skin wasn’t broken or bleeding, where your report says Ulceration- Not Identified, clearly state when you get the second opinion how the skin above was so they know it was not ulcerated, since ulceration effects staging. The cancer center that I went to for a review of my slides did change some of the numbers from the initial path report, so don’t be surprised if you see some of the data change. The Breslow depth works in your favor. Good luck, let us know how it works out.February 23, 2013 at 4:41 pm #59317 Thanks for all the advise it is helpfull, I have been trying to gather as much insite as I can prior to wed visit with the surgical oncologist Dr. Adam Riker at advocate in tinly park Illinois. (any body have any feedback on him would be helpfull as well). I’ll ne sure to update after Wedwhen o know more seems like things are favorable but with some not normal results. Ie mitosos rate
Thanks again for all your inputFebruary 23, 2013 at 6:08 pm #59318WorrywartParticipant
Your Breslow is fairly low risk, but due to the regression and mitotic rate I’d push for the SNB. Your tumor infiltrating lymphocytes were brisk which indicates your body was aggressively attacking this lesion – that is good, but probably contributed to the regression. The only bad thing about regression is that sometimes it indicates your lesion could be deeper than what the path report states. Regression basically means yoru body was ‘eating’ it. Your deep margin was not involved, which is good. Your peripheral was involved, so there may still be some cancer cells left on your skin. This is fairly common with melanoma however. By “melanoma in duty” do you mean melanoma in situ? I have no idea what in-duty is?? Approx 8% of the melanoma population has more than one melanoma. You should consider mole mapping/photography to track your moles for change and new growth. A second opinion on pathology is usually covered by insurance and I consider it VERY important with any cancer diagnosis! Good luck at your appt!February 23, 2013 at 6:17 pm #59319
Thanks for the input and yes in situ it should have read auto correct that i missed. This all came about from my first Derm visit to have a lump under a mole on side of my neck checked. Just a sist they said and had them check me out. I do have many moles and all the other negativefair skin green eyes red blnd hair ect. Thanks again for all the inputFebruary 23, 2013 at 7:34 pm #59320krissy424Participant It’s good that the path report
stated No Ulceration. Just to clarify a point, my SSM had a bleeding gouge near the top
of the lesion. It was from my fingernail. I had No Ulceration and was told
that was something seen in the lab with microscope, not with the naked eye.February 23, 2013 at 11:30 pm #59321WorrywartParticipant
Did they biopsy that lump under a mole to confirm it was a cyst?February 24, 2013 at 7:56 pm #59322 No they did not do biopsy. Quick look and said cyst and my choice to have it removed or not thinking I will have them take it off now and sent in for piece of mindMarch 5, 2013 at 1:30 pm #59323 Just a update I had my wle and slnb yesterday all went well 2 nodes removed in left arm and 1 on right side. Now just the waiting game again to get the pathology back. Thanks to all for your input on this it has been helpful.
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