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October 3, 2012 at 10:10 pm #20662BradRParticipant
My 31 year old wife was diagnosed with a nodular amelanotic melanoma at the end of August behind her ear. The lesion was shave biopsied and cauterized by her dermotologist; he thought it might have been a bcc, one week before the diagnosis. The path report said no mitosis, unulcerated, with breslow at least 3.7mm. We were devastated by the news of course. We have a 2 and a half year old daughter and a one year old son. The next week she had a WLE and SNB. The path report on those came back all negative, including the tissue the lesion was originally on. We were very excited and her surgeon was baffled that there were no melanoma cells on any of the tissue taken by the WLE and the SNB. A second look at the original path report still yielded melanoma. We know we should go consult with an oncologist, but is there commonly any next immediate step?October 3, 2012 at 10:33 pm #568067spiderParticipant I think as long as everything came back all clear after surgery, she’ll just need to have skin exams every three months and keep a close eye on things. Might also consider having slides from biopsy read by a melanoma expert.October 4, 2012 at 1:44 am #56807Lisa PParticipant First, I am so sorry to hear that you and your wife are going through this. I can’t imagine how stressful it must be dealing with the fear and concern you are experiencing at the same time as having two young children to care for. In the end, no one else walks in your shoes, but I have taken the approach with my own health care plan to get several sets of eyes on me every few months with a number of different specialists. While I don’t necessarily recommend such an aggressive plan for everyone, at a minimum, I always suggest erring on the side of caution whenever someone has uncertainty or questions about a specific diagnosis or pathology report. I personally don’t see any downside to you and your wife talking to an oncologist who has had a lot of experience with melanoma, who can hopefully confirm that all is well and provide advice about a long-term monitoring plan. Please take care and keep us posted. LOctober 4, 2012 at 12:04 pm #56808Catherine PooleKeymaster I would recommend you consult with a melanoma specialist and be followed closely. I also think a second opinion on the pathology is probably a good idea. Where are you located? I am a little concerned about the procedure your first doctor performed! So I would move on to someone experienced with melanoma.October 4, 2012 at 1:33 pm #56809BradRParticipantQuote:
Where are you located?
We are in San Antonio, Texas. I believe a shave biopsy is standard operating procedure for a suspected bcc. Her dermotologist was just as surprised as we were. After her diagnosis he punch biopsied another mole that had a halo and it was negative. Thank you for the replys and well wishes.October 4, 2012 at 7:16 pm #56810Catherine PooleKeymaster
Until a dermatologist knows what a lesion truly is, an excisional biopsy is best. A deep shave is next best and punch biopsy least preferred for pathology testing. Your wife may qualify for the Mage A3 trial available at MD Anderson: Patrick Hwu, MD 713-792-2921 . It is promising for stage 11/111.October 4, 2012 at 9:44 pm #56811WorrywartParticipant I am sorry Brad. Congrats on clear SNB. As Catherine suggested, I’d look into trials. I’m really surprised that a melanoma that deep had no mitosis. I’d seek a third opinion from a dermatopathologist that specializes in melanoma. Do you have a copy of the path report? How long was this lesion present?October 5, 2012 at 3:15 pm #56812LaurieParticipant Brad, my thoughts and prayers are with your wife, yourself and your kids. Kudos for being a very supportive husband (I know how much my husband’s support has helped me). This site is a great place for information, questions and support. As others have stated, your wife should see a melanoma specialist to be sure she is getting the correct diagnosis and treatment. Catherine is a great resource and knows countless others who have information. Please know that you and your wife are not alone in this.
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