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October 31, 2012 at 10:52 pm #20726
Hello. Yesterday I was given the news that my doctor found melanoma in 2 moles I had removed recently. One, which was on my breast came up as in-situ melanoma. The other spot on my upper arm is malignant melanoma. The pathology report says: malignant melanoma, Spitzoid type, nonulcerated, clark 4, Breslow depth 1.1mm, inked margins are uninvolved.
I am 35 years old and am 35 weeks pregnant with my first. Tomorrow morning I have an appointment to have both spots further removed. Being pregnant I will have to wait have the SLN procedure done until after I have the baby. This has all been a big shock to me and has turned the happiest most exciting time of my life into the scariest. Can anybody give me any insight into what I am facing?November 1, 2012 at 10:00 am #57254krissy424Participant
i wanted to welcome you to the MIF forum. Seems i must be the only one who didn’t go out for Halloween. Lots of very knowledgeable people here. Sorry to hear you are expecting your precious child and have to deal with melanoma. I fear I don’t know much about Spitzoid type disease. I’m sure by morning some members will come in that can help you. i wanted to post and let you know you are not alone. The help you need is here.
Can i ask, do you have a melanoma specialist affiliated with teaching hospital or one of the major cancer centers that treat melanoma? Have you thought about having a second Dermatopathologists read your slides? That’s always an excellent idea.
hang on, the gang will be in.
KrisNovember 1, 2012 at 10:27 am #57255
Thank you so much for your response Kris. I will definitely look into finding a melanoma specialist in my area.
I am seeing my doctor today for the WLE. Any suggestions of questions I should ask? He is also referring me to an oncologist and wants me to meet with her this week. Also, I have read that it is best to have the WLE and SNB done at the same time. Since I am pregnant and can’t have the SNB done now is it going to be inaccurate?
Thank you in advance. Just knowing this website is here has already made me feel a little bit better.
KatieNovember 1, 2012 at 11:52 am #57256
I am so sorry to hear about your stressful situation. I was there myself 23 years ago, pregnant with my son. 1.1 is just over the margin for having the SLNB. I see nothing else that indicates higher risk in your report. I do think you should get an expert opinion on the pathology report. That can easily be done by having the slides sent to a top place like Sloan Kettering, Johns Hopkins, etc. or Dr. Mihm (has online services:drmihm.com expert from Brigham Women’s) What part of the country do you live in. We can help you find an expert. We are here to support you and we’re happy you found us.
(PS did they report a mitotic figure?)November 1, 2012 at 11:56 am #57257
One more thing to add. In my pathology report it says: mitotic rate- none identified. I am not sure if that is a good or bad thing. I have seen mitotic rate mentioned on here a lot and am hoping that none identified is a good thing.
KatieNovember 1, 2012 at 12:01 pm #57258
Thank you for your response Catherine. I must have been typing my post about the mitotic rate at the same time! I live about an hour northwest of Chicago, so hoping there are some great doctors close to me.November 1, 2012 at 12:23 pm #57259 What I know of:
Dr Kaufman at Rush
Dr Kuzel at Northwestern
Dr Brockstein at NorthShore
Dr Gajewski at U of Chicago
Dr Richards at Lutheran General
Dr Clark at Loyola
Those are oncologists (not sure if you’d need that), and as far as the surgery:
Dr Winchester Jr, NorthShore University HealthSystems
Dr Yao, NorthShore University HealthSystems
Dr Sharpless, Lake Forest
Dr Wayne, NorthwesternNovember 1, 2012 at 12:32 pm #57260
As far as your question about is it best to have the WLE and SNB done at the same time: I’m not a doctor, but this is what I understand, others can correct me if I’m wrong: SNB should be done prior to the WLE to have real value. The WLE removes a lot of tissue. It may alter the drainage paths to the sentinel node. The “sentinel node” they find after the WLE might not be the same one they would have found before the WLE. The SNB and WLE are typically done in the same setting with the SNB first, followed by the WLE.November 1, 2012 at 12:34 pm #57261 Final note: You’re 35 weeks pregnant, so you’re much much further along, but when my wife was 12-13 weeks pregnant she had surgery (used general anesthesia) to place a transabdominal cerclage to prevent preterm labor. 2 1/2 years later our twins are doing just fine.November 1, 2012 at 1:05 pm #57262 My doctor said that it would not be safe to have the radioactive dye injected while I’m pregnant.November 1, 2012 at 1:27 pm #57263 good point, that is a different aspect to this surgery that wasn’t part of the surgery my wife had while pregnantNovember 1, 2012 at 2:13 pm #57264 I’m about 30 miles north of Chicago – if you have any questions on the doctors i’ve seen, etc. . i’d be happy to share my opinions with youNovember 1, 2012 at 3:39 pm #57265 Yes, there is some risk with the radioactive dye. The lack of mitotic rate is a good thing! It means there wasn’t a lot of cellular activity or growth going on. There are many folks who do go for the SLNB later than the WLE. No great amount of evidence really that it would be less accurate if you did opt for it later. Again, I would just make sure you get a second opinion on the pathology slides from an expert. This is an easy scenario of shipping and Boris Bastian at SLoan Kettering Cancer Center in NYC is the top expert about spitzoid nevus which was in your path report. Of course NYC is under water right now, so you may want to send slides to http://www.drmihm.comfor an opinion. He is very expert!
When I was pregnant and going through this scare, it helped me to do deep breathing, meditation and yoga stretches. It really helps!!November 2, 2012 at 4:05 pm #57266
Thank you so much to everybody for all of the advice! I had my WLE yesterday and everything went well, although my arm is pretty sore today. I discussed the SLNB with the doctor and he reassured me that it was best to wait because of the risk to the baby. The doctor also told me that when he had originally removed the mole on my arm that he had removed all of it because the margins were clear. So hopefully that is a good sign. I feel a lot better about things today, everyday has gotten a little easier since the initial shock. The doctor also told me that the risk of it spreading to my lymph nodes was pretty low. Do you think that is the case, considering my pathology?
Also, I was wondering if anybody knows if there is any connection between the pregnancy and the development of melanoma? I plan on having more children after this so just wondering if this will be a concern for the future. I will be followed closely and checked regularly by the dermatologist but just wondering if another pregnancy would put me at a higher risk.
Thanks again for all of your advice, this is a very helpful website!November 2, 2012 at 4:44 pm #57267
Glad you are on the road to recovery. Your doctor will tell you to wait two years before getting pregnant again since that may be the possible time of recurrence. There is no great body of evidence that pregnancy causes melanoma to grow, at least there is no hormonal connection. Hope you heal well and take good care with lots of sleep because soon you won’t be sleeping much at all!
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