Home Forums Melanoma: Newly Diagnosed – Stages I & II Newly diagnosed in Dec and have a few questions.

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    Hi Everyone. I am new to the site and just diagnosed in December. Here is some info about this journey I am taking now.

    Quick Bio.

    Diagnosed back in December. I noticed the mole last October and was larger then a pencil eraser and just brushed it off due to pregnancy. I found a picture from 2010 and nothing was there. That prompted my old family Dr(We moved in Aug and just found a new dr accepting patients in our town on the 6th of Jan) to give me a referral, after getting him to look at it a few times at my new borns doctor check ups. I also asked my OB about it as well at my 6 week after delivery check up and he also thought it was nothing too. Thank god I found a picture and got that referral.

    Had a Shave biopsy Nov 27th, 2013. Pathology results “Surgicial incision with 1 cm MA of skin. Left thigh. Superficial Spreading Malignant Melanoma. Level 2 invasion, vertical height 0.47- No ulceration. Mitotic index is one mitosis per 1 mm squared.”

    WLE Dec 31st. Pathology results appointment Jan 29th. Feels like it will never come!

    So on January 10th lymph nodes in groin were tender and felt bumps in a few spots on left side. Went to family Dr on Monday the 13th. He felt it and said that he doesn’t think its a tumor but said that he felt a few and it could be because of the WLE and is just fighting the possible infection I could have. However he couldn’t tell because of all the bruising which is huge. Not hot to the touch, so he said play it by ear for now and should it get warm, to go and see him and he will write a prescription. Still breast feeding so don’t want to take it if its not infected and have to stop just to play a guessing game. He did however want to have an ultrasound done on my lymph nodes to check for sure. I have an appointment on the 28th of Jan for that. Swollen Lymph nodes are still there but not as tender like they used to be.

    So first question. Has anyone ever had a ultrasound to check lymph nodes? I can’t find anywhere on the web where it says that one would use an ultrasound to check lymph nodes. Should I get a needle biopsy just to be sure or something else?

    Second question. I have my first full body check on Thursday and I would like to hear other peoples experiences and what to expect. I am still upset that my derm did shave instead of a punch (Shave Biopsy is all they do there) and I want to make sure this time I am informed going in. Last time I just went along with what they said because I didn’t know any better. I could have asked for a different derm that actually did punches. Unfortunately now I will never know the true depth. My family dr is going to set me up with someone, in addition to my derm. He had training in Australia for Melanoma “detection”(Not the proper term) So I can have two sets of eyes, which will be nice. Is there anything that I should make sure they do for the full body check up?

    Any answers are greatly appreciated.

    Thank you to all who have posted their stories and experiences. It helps a lot.


    Catherine Poole

    Welcome to our forum. I really do think you need a second opinion on both your pathology and your current situation. Ultrasounds are done (more frequently in other nations) to check on lymph nodes. How accurate they are for detecting disease I’m uncertain. Can you get to a center of excellence to review your situation?


    Hi Catherine and thank you for your reply.

    I have not been to a Center of excellence. I live in Wasaga Beach, Ontario, Canada. I googled after I read your post and believe the closest ones would be in Toronto which is only 90 mins away. Is there one that you would recommend so I can get on this and get a second opinion?

    If I could pick your brain for a little while that would be so helpful.

    I have my wle results next week. Are there any questions that I should be asking? I am currently watching the video on the website “Understanding your melanoma pathology” to get a better understanding.

    Would I want a second opinion of my results as well as a different person to view the biopsied skin? If so, do you know how long do they keep the biopsy skin for?

    Seeing how they did the shave biopsy, how am I t be sure that I would not be at a different level them what they come back saying? I read that a true depth will not be known now. Is there a certain mm range that they take into account when doing the WLE results?

    Sorry for asking these questions. It has been a hard month waiting for the results. My family dr called my surgeons secretary to try and get the results however she won’t release them. I called then and she said the surgeon will go over it with me at my appointent which was 2 week away and have already waited 2 weeks. The surgeon was out of the country and she said that the results are on her desk and if it is urgent she will call you. With the lymph nodes being swollen I called her office first as the surgeon checked them after my WLE and they were fine. The secretary said call my family doctor that she will not see me for that.

    I am going to have a good talk with my surgeon about her secretaries phone manner and how I don’t appreciate it. I have been worried about making people angry and not getting the right care but I really need to stop worrying about stepping on toes as I have never been this way before and now is defiantely not the time to start.

    Thank you!

    Catherine Poole

    You could have your slides sent (not the actual skin) and you might try expert Dr. Mihm, http://www.drmihm.com and they are quite good there. He is Harvard trained and world renown. He did the video you watched. That might be best. Go to his website to learn more.


    Thank you Catherine for your help and the link. I will contact Dr. Mihm for a second opinion.

    Greatly appreciated!


    sounds like it was caught pretty early which is good


    Hi Yvonne,

    My name is Wendy and I live in Ontario as well. Also had a .47mm, Level 2 SSM, back in 2011. I can understand the worry you are going through – it’s natural and it will pass. By far the greatest probability is that you will be absolutely fine.

    I just wanted to poke my head in here about the depth. Shave biosies of small skin lesions are common, and a deep shave can easily be more than 1 mm thick. If the pathologist who examined it could not see the bottom of the lesion, he/she would not simply have assigned it a depth, but rather would have indictated, “lesion extends beyond the bottom of the biopsied material” or similar wording. They always have to indicate if the lesion extends past any edge of what they have been presented with.

    Hope this helps, and that your further appointments are reassuring.

    Best wishes,



    Hi Wendy,

    Thank you for saying that about the shave biopsy. Your the first person to mention that. Puts my mind to ease. I read my path report and it does’t say that anywhere. Fingers crossed for clear margins on wednesday.

    Thanks cohanja as well.

    Catherine Poole

    The last research I saw on biopsies stated: excisional the best, deep shave second, and punch least favored for accuracy. Good to see you Wendy, we’ve missed you!!


    I had my WLE results appointment on Wednesday and it was good news. Posted my path report below. Thank you to everyone who answered my questions this past few weeks.

    I had my full body check up last week to and they want to do 5 more biopsy’s. I talked with my surgeon and she said that instead of my dermatologist doing the them that she will do them from here on in. So I will have 3 biopsy’s done first and then the other 2. In Ontario, our healthcare will only allow them to do 3 at a time apparently.

    Catherine, I would be really interested in reading the research on Shave’s over punch’s, if you happen to have a link for it. I have only read of it being the other way, from the studies I saw. Would you happen to have that?

    Ultrasound appointment is Tuesday for the results of my lymph nodes. The guy said they just look like lymph nodes so I feel good about Tuesday. The surgeon also checked and she said that they just feel reactive. I am healing nicely now and bruising is almost gone. She took the tape off and you can barely tell it is there. So we are done with this spot and on to the others. Lets hope they are just little dark ugly moles.





    Gross Description

    The specimen is received in formalin in one part.

    Part A is labelled with patient identifiers only and consists of an ellipse of skin and subcutaneous tissue measuring 3.5 x 2.2 x 2.3cm, in the center of the surface is a wrinkled slightly concave gray tan oval area measuring approximately 1.3 x 1 cm, coming to within 0.4cm of the closet margin. Marker with silver nitrate, serially sectioned and all submitted in blocks A1-A11. Ic

    Final diagnosis

    A. Skin left buttock, excision:

    -Skin with underlying dermal scar and biopsy site changes

    -Negative for Residual in Situ or Invasive Melanoma

    She got it all in the shave biopsy!

    Catherine Poole

    Great news! Thanks for letting us know.


    Thanks Catherine!

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