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December 23, 2012 at 2:29 am #20871
I am a 60 yr. old male and was recently diagnosed with melanoma on left leg on inner thigh near the knee. The pathology report did not mention a stage. I had WLE on 12/19/12. Below is the pathology report:
Malignant melanoma, superficial spreading type, Clark’s level III, Breslow’s thickness at least 0.3 mm below the granular layer, possibly arising in pre-existing nevus.
Vertical growth phase – identified
Vertical growth phase – no
Regression – no
Mitiotic figures – less than one mitotic figure per mm squared
Ulceration – no
Lymphovascular invasion – no
Satelitosis – no
Tumor – infilterating lymphocytes – non-brisk
Associated melanocytic nevus – yes
Predominate cytology – superficial spreading
There is some nuclear variability and pleomorphism to both lateral margins of the shave biopsy.
There was no node biopsy.
After the the WLE, I asked the Derm. Surgeon about the stage of the biopsy, and he said something like this was caught very early and he did not give me a stage. I thought this a little odd. He also said that being a male, there was probably about a 7% chance of the cancer spreading to my organs. I am going to have a chest x ray on 12/28 and I am also going to see a oncology surgeon for a second opinion on 12/26. Help please!December 23, 2012 at 10:39 am #58126cohanjaParticipant
Sorry you joined us. Catherine and others can help clarify (I’m not a medical professional), but I’d point out a few things from what I see: are you sure it doesn’t say “Radial growth phase – identified, Vertical growth phase -no”? You typed “Vertical growth phase” twice. With 0.3mm Breslow, no regression and low/no mitosis, no ulceration. . this seems low risk (almost identical to mine, except mine was on my back, and yours is on extremity which is even better). In most cases, I don’t think most doctors would even do chest xray, I didn’t have any scans/imaging until more than a year later, only cause I kept asking. I also think 7% chance of metastasis is too high, because this seems like stage IA and in most cases that is in the high 90s for 5-10 year survival, and maybe it’s not 100% because of mistakes in pathology. This thin without vertical growth phase is very difficult biologically for it to spread. Obviously, a melanoma diagnosis is not to be taken lightly, it’s very serious always, it’s an unpredictable illness, it means very close skin monitoring for life, etc. . but in the big picture I believe this is pretty lower risk. Another opinion is always a good idea too.December 23, 2012 at 12:55 pm #58127Catherine PooleKeymaster This is very low risk and you have reason to celebrate! If I were to get a second opinion on this it would not be from a surgical oncologist, but instead another pathologist, a dermatopathologist. But the Breslow depth of .03 is incredibly low risk and no vertical growth phase or mitotic factor again points to virtually no chance of this spreading. Congrats on finding this early! And chest xrays really aren’t a great follow up tool any longer. Just go in for skin exams and examine your own skin regularly. Please utilize our tools above in Might want to check out the webinar on Pathology, the Newly Diagnosed tab and the melanoma terms tab. BLUEDecember 23, 2012 at 5:13 pm #58128 Cohanja, you are correct, it does say radial growth phase identified. I got in a hurry.
Catherine, as you can see, I have no experience with melanoma. Would I just take my pathology report to another dermatophathologist, or would they need the biopsy tissue?
I want to thank both of you and others in this wonderful forum. I feel a lot better after your responses. I am very fair and love to play golf. I use sunscreen but I did not use as much screen on my legs. I will be more vigilant in the future. I will visit this site often to give updates and support to other patients.
Thanks again for the great information!December 26, 2012 at 8:26 pm #58129WorrywartParticipant
Hi there! Sorry you had to join us. A cancer dx is always very scary, but luckily you caught it early. Some studies even say radial growth phase has no ability to metastasize. To obtain a second opinion, locate a dermatopathologist from a teaching school and/or get ideas from this site. Get the address of where to send slides (will be on website), call your derm and have him/her send the slides off for a second opinion. If you have health insurance this will most likely be covered. A second opinion should be a part of every cancer dx because pathology is an art, not a science. Keep a close eye on your skin for change and wear protective clothing more so than sunblock (works better).January 18, 2013 at 3:32 am #58130 Thanks so much for all the great information. I really do feel a lot better since I read all your replies.
This is a very informative site.
TerryJanuary 19, 2013 at 12:30 am #58131krissy424Participant
Happy to read your path report and know you have an excellent prognosis, Terry.
I’m 60 also and had a melanoma removed in June 2012. Superficial spreading, radial growth phase, breslow .55, clark II, no regression, no ulceration, on upper back.
This forum provides a wealth of accurate information and can help you learn about melanoma so you can in turn educate others. We all want to get the word out-
Melanoma is not ‘just skin cancer.” It’s a very aggressive deadly form of cancer that’s treated easily if found early and very difficult to treat in the later stages. It also seems to come back when least expected for some people. Of course prevention is the gold standard.
Again, welcome to MIF, Terry.
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