Home Forums Melanoma: Newly Diagnosed – Stages I & II Newly Dx and scared……

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  • #20895
    Nicky6410
    Participant

    Hi Everyone and Happy New Year

    Just dx and new to this but not new to CA unfortunately previous breast cancer with mastectomy and SLN. I am scheduled for a wide excision bx and another SLN later in the month. One of my concerns is that my melanoma is on my back and I have read that it is usually difficult to find which lymph node group (the groin, arm, etc) a melanoma on the back has traveled to when it is situated on your trunk. (I already do not have any type of blood draw, blood pressure cuff done on the left arm and am worried that now the right arm will be affected). Does anyone know if they can accurately pinpoint the affected lymph node when the melanoma is on your back?

    I hope I am making my question clear enough. I am still shell-shocked over this dx I received the day after Christmas and I really don’t think I am thinking clearly. Having cancer again has really brought everything back in a very sad, sad way. Having trouble thinking this through clearly.

    Thanks so much for any help you can share. I really appreciate it.

    #58324
    cohanja
    Participant

    Hi, sorry you’re going through this. My melanoma was on my back as well, and all I can tell you is what they did for my SLNB: They did lymphangioscintography – they injected radionuclide in the four quadrants surrounding my melanoma biopsy site in my left upper back, images were begun immediately following radionuclide administration, initial images showed lymphatic channels extending toward the left axillary region with left axillary lymph nodes visualized, no lymph nodes visualized in the right axilla nor in the cervical region, sentinel nodes also not visualized in the inguinal regions. Images were taken and sent to the operating room. So I had 2 nodes removed from under my left arm. I hope this is an accurate way of determining which nodes are sentinel. . . it’s what was done in my experience. Do you have your pathology with Breslow, mitotic rate, etc. .details?

    #58325
    Nicky6410
    Participant

    Thanks for the reply. So if I am understanding this correctly by injecting near the melanoma site the dye will travel to all lymphatic sites not just the site that is near? I have read that it is difficult to find if the melanoma that is not on a limb.

    I do have the path report and trying to decipher line by line but it is tough for a novice ( which I realize I probably won’t be for long).

    Class: superficial spreading

    Clark’s level: III

    Breslow: 0.81

    Host response: non-brisk

    Regression: present, superificial

    Mitosis: 1/mm

    Growth phase: vertical. (I know that is not good)

    Satelillitosis: not identified

    Ulceration: absent

    Angiolympathatic: not identified

    Neurotrolpism: not identified

    Margins: Melanoma in situ and regression changes extending to a peripheral margin

    Co-existing Nevis: present, intradrrmal Nevis

    If anyone out there can see positive items here in this report Please let me know. Anything I need to be concerned about addressing on my upcoming appointment will also be very helpful.

    So thankful for finding this forum. Think it already is a life saver for so many.

    Thanks to all for your help.

    #58326
    Worrywart
    Participant

    I am sorry you’ve been dx with another cancer. How long ago was your breast cancer?

    As for your path report, here are the positives:

    1. low mitosis (not a fast growing cancer)

    2. your breslow is pretty shallow and in some places they don’t even do a node biopsy until the melanoma is over 1mm.

    I believe Catherine’s stats were similar to yours, and she is over 20 yrs out from her melanoma.

    Hang in there! You can get past this!

    #58327
    cohanja
    Participant

    No ulceration is good. And, if by “Regression: present, superificial” they mean the regression was not extensive, that is good. Less than 1mm is good. Not being Clark IV or V is good. You can watch Dr Mihm’s webinar on pathology as well to try and understand more.

    As far as the lymphangioscintography, as I understand it the dye will travel wherever the drainage pattern is, wherever that may lead to. So, they are able to see which nodes light up. I don’t know if it’s a perfect procedure, I haven’t heard a difference between doing it limbs vs trunk.

    #58328
    krissy424
    Participant

    My melanoma was on my upper back. SNB was not recommended because the breslow was .55 and clark ll, radial growth phase. I would never have lymph nodes removed unless absolutely necessary and recommended by the melanoma specialist.

    Quote:

    I do have the path report and trying to decipher line by line but it is tough for a novice ( which I realize I probably won’t be for long).

    I can identify with your comment. I went from zero to understanding both the basics and about treatment almost over night. I’m shocked by how many family practice docs have limited knowledge and often know very little about the newest treatments. Stage 2-4 really need to become experts on their disease and have a forum like MIF for help navigating treatments including the Clinical Trials.

    We are here to help you. I’m stage 1A and was every bit as frightened as the people with more advanced disease in the beginning.

    Kris

    #58329
    Nicky6410
    Participant

    Appreciate the replies…my head is spinning but you guys are making the revolutions slow down a little. Thanks

    #58330
    Lisa P
    Participant

    Hi, Nicky – I can imagine how upset you are reight now, but here are some positives from my persperctive. First as folks have said your melanoma is less than 1.0 mm, which is usually the baseline for doing anything more than a WLE. I had two melanomas on my back and a whole bunch of moderately (and a couple of severely) dysplastic nevi removed from there as well. It would be good for you to get in to see your doctor (assuming he/she is a skin cancer specialist who is very knowledgable about melanoma). Otherwise, I’d immediately to research to find someone who is. With that, I suspect you’ll likely get assurance that you got this one early and you’re going to be fine. In the meantime, try to breathe deep and take it easy. Take good care, Lisa

    #58331
    Nicky6410
    Participant

    Thanks Lisa…..really trying to take a deep breath. This brings back alot of sadness from the breast CA. Hopefully in a few days I’ll be able to put on my big girl panties and get a grip! Thanks to all who have responded.

    #58332
    Lisa P
    Participant

    Unfortunately, there are no panties that are quite big enough to address this kind of thing. Just breathe deep and make sure you have lots of friends and famly around you over the next few days to help you get through this sucky time! Hang in… L.

    #58333
    idahogirl
    Participant

    Hi Nicky,

    I received my dx the day after you…two days after Christmas. I am still in shock, too. They day my doc called and told me, he had me come in an he performed the WLE. Now I’m kind of upset because it is my understanding (having done my research AFTER the WLE) the SNB is more accurate if done at the same time. Are you not having them done at the same time?

    It is so nice to have found this site and knowledgeable people to give encouragement.

    It definitely is scary stuff. But we are both lucky that it was found early!

    #58334
    Nicky6410
    Participant

    Hi

    Scary stuff huh Idaho. I am having both done on the same day but have to go to a consultation and preop work on the 15th and then a surgery date will be set. Very nervous to have to wait that long but no other options.

    Trying to get a handle on the path report line by line. Some aspects sound promising and some not so much. So I hope it was caught earlier enough. Really strange because my breast cancer oncologist saw it in mid December and didn’t say anything and my doctor that took it off almost didn’t send it in for pathology because she didn’t think it was anything and I couldn’t see it at all because it was on my back. The only reason I did anything about it was because it kept rubbing against my bra and caused it to sting and burn.

    Agree this forum is God sent for sure. Keep us posted and we will keep you in our prayers.

    #58335
    cohanja
    Participant

    My primary care physician saw me a week before, and said there’s nothing of concern. I went to the derm anyway for my scheduled appt and even though he did biopsy he said he was 99% sure it would be nothing. Turned out to be melanoma. Some lesions don’t follow the typical Asymmetry, Border, Color, Diameter, etc. . of melanoma, some look innocent.

    #58336
    Catherine Poole
    Keymaster

    As Worrywart pointed out, my melanoma was a .76 depth, vertical growth phase, mitosis of 1, and very similar to your report. The number one important variable is the depth, or the Breslow level which as a few others have reassured you is below where many docs recommend the SLNB. I understand your concern about the SLNB and I would just make sure you are seeing someone who does a lot of these procedures in a teaching facility. It has been done in breast cancer longer than melanoma, so that is fine if you go to a breast ca specialist for the SLNB. It is important to take care of your head too, deep breathing, meditation, and anti anxiety meds/anti depressents can be very helpful during this time of stress. Don’t hesitate to ask your doc for some meds to help you through. Aerobic exercise is also very helpful for stress reduction. Oh, and I am now 23 years out from my melanoma and recently became a grandmother! Everyone here is wonderful, so please come here often for support.

    #58337
    Catherine Poole
    Keymaster

    Nicky,

    Write me at: cpoole@melanomainternational.org

    and I can reply easier than through this system..thanks

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