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July 9, 2012 at 4:20 am #20458ida17Participant
my sister has noticed a mole in her legs that has started to change color. We went to the dermatologist for a dermatoscopy, and it turns out to be suspected melanoma.
We went then to see a surgeon, and he said that we have to remove this, but before this my sister has to do, inguinal ultrasound to see if the melanoma has reached the lymph nodes and an abdominal ultrasound. It comes out that everything was fine.
Next week, she will remove the mole and to see what comes out from the biopsy.
This forum is very helpful, that why I shared with you this experience.
If you have any comment, or suggest you can write to me.
thnx in advance.July 9, 2012 at 6:31 am #55344Catherine PooleKeymaster
I’m not sure where you live, but it doesn’t sound like in the U.S. Here, we would first remove the mole to see if it is melanoma for certain, and how deep it is. Then other tests would be ordered if necessary. A sentinel node biopsy would be ordered if it is over .76-1.00. I hope she gets the removal taken care of as soon as possible. Please let us know how things are going..July 9, 2012 at 11:57 am #55345 i agree with cathrine i am from ireland and the biopsy is the first thing they do here if melanoma is suspected.type in this search term (royal college of surgeons in ireland guidelines for melanoma)pay partictular attention to the part headed(biopsy of a suspected melanoma).the usuall steps in treating melanoma are 1 excisional biopsy(elliptical) which removes the complete mole .2 if melanoma is diagnosed and no sentinel lymph node biopsy is needed then the next step would be a wider excision around the biopsy site .3 if a s.l.n.b is needed then the s.l.n.b and the wider excision are done together,this is the reason why the melanoma guidelines call for longitudinal orentation of the biopsy in the extremites and narrow margins .if the wide excision is done prior to s.l.n .b it may cause the lymph mapping procedure that is done prior to the s.l n.b to be less accurate.the lymph mapping is done by injecting a blue dye and radio active substance in to the the biopsy site to enable the surgeons to find the sentinal node that they then remove to test to see if they contain any cells that may have come from the mole.jameslukeJuly 9, 2012 at 1:11 pm #55346 Jamesluke, the Irish guidelines from your link are dated 2006 and have therefore been superseded by the 2010 guidelines. The following link from the British Association of Dermatologists has been very helpful for me as it contains a lot of useful detail:July 9, 2012 at 1:16 pm #55347 Sorry, I cut and pasted the link but it doesn’t come out correctly. So I’ve typed this out and hopefully it will workJuly 9, 2012 at 7:39 pm #55348 bon.the british assocation of dermatoligsts guidelines are easily accessed on there website.the biopsy of a suspected melanoma section on the irish guidlines is still current even though they are from 2006.as you know good surgery done in the correct order and done as early as possible is still the best way to effect a cure for melanoma.i have read guidelines from austraila ,ireland, the uk, usa and they are all pretty much the same, i think i am right in saying that the national comprehensive cancer network guidelines were updated this year.i think the basic information any person who suspects they may have melanoma should know is, what type of biopsy is recomended for melanoma(excisional biopsy(elliptical)if possible, and the fact that if they end up needing a sentinel lymph node biopsy then the wide excision should not be done prior to s.l.n.b.thats the main msg i was trying to get across to the person who posted.jameslukeJuly 9, 2012 at 9:08 pm #55349 I note this quote from the Irish guidelines:
“Shave and punch biopsies are not
recommended (because pathological staging of
lesions on these biopsies is impossible).”
I would contradict the assertion about punch biopsies. My biopsy was a punch, taken only four months ago. I had a punch biopsy as my dermatologist was 99% certain there was no malignancy. It turned out there was (stage 1a) but the biopsy showed both clear lateral and deep margins (confirmed by subsequent wle) and my pathological staging was not compromised in any way.
My melanoma was only 5mm wide and I do agree that an excisional biopsy is best, particularly if the lesion is too big to be fully removed by the punch.July 9, 2012 at 10:57 pm #55350cohanjaParticipant
I think after excisional biopsy, deep shave (saucerization) is next best to get good margins?July 10, 2012 at 8:11 pm #55351 bon . i agree your experience with the punch method of biopsy does contradict that quote from the irish guidelines ,probably time they had a look at updating them.jameslukeAugust 2, 2012 at 6:22 am #55352ida17Participant Hi,
thank you for you posts and I’m sorry but I didn’t have time to write to the forum. My sister did the surgery 10 days ago, and Tuesday she got the biopsy results. The doctor said it wasn’t melanoma. We don’t have the biopsy result printed, but as soon as we will get them I will write what exactly the results are.
This experience had made me to be more concerned about the sun and the damage it can cause. That means, now on I should definitely wear suncream with a high SPF factor while sunbathing.
Take care guys!August 3, 2012 at 2:59 pm #55353Catherine PooleKeymaster
That’s great news! Let us know what the pathology said.
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