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Old 05-26-2019, 01:26 AM   #1
JessicaV
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Melanoma Biopsy when almost 5yrs NED BC.

I have a flat irregular pigmented area about 1.3cm across just below my right collarbone. I get Molemaps most years, tho missed from Nov 2015 to May 2019. It was chopped in half in 2014 when my breast surgeon cut out a 6mm lipoma at my request when removing my left breast. It has been there since at least 2011 when I had my first molemap.I questioned it with Molemap in 2015 and their specialist said no cause for concern. This time, the dermatographer was worried and so was their dermatologist.
Took it on Friday to a Moh surgeon/dermatologist Carl who teaches dermatology at the local med school and also sees a lot of skin cancer patients of all kinds and has been doing this work for nearly 30 yrs. He said it is very likely a melanoma. He was concerned it had not been chopped out by the breast surgeon. And had not been queried by the molemap people before now. He thinks it is probably a melanoma. He did a shave biopsy. I asked if it could be contamination from the breast cancer op, or skin met from the Breast cancer. He said he didn't think it could possibly be either. They will stage it from the biopsy, if it is melanoma, and let me know results by txt on Monday or Tuesday.
I am really not sure what to make of this whole situation, am a bit concerned that I have no idea of the processes or other things that are relevant with Melanoma, esp after early breast cancer. Can anyone help+
Are there any questions I should be asking, anything I should be getting checked, eg the HER2+ status?
__________________
1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan
14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and
Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.

March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.
May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets.
Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.

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Old 05-26-2019, 02:52 AM   #2
Lucy
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Join Date: Oct 2014
Posts: 293
Re: Melanoma Biopsy when almost 5yrs NED BC.

Jessica,

I don't have any questions for you to ask but I think the best advice I could offer is to try to not dwell on what might be until you have some more details about what it is. Very hard to do, I know. Having gone through what we've had to deal with having cancer, the imagination likes to run wild when we don't have the facts to back up potential theories. Not that it helps a thing but I've been told that's normal. Once you have some answers you can go from there. In the meantime try to relax and know you have our support and prayers here!

Let us know how it goes.
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Old 05-26-2019, 06:09 AM   #3
Lucy
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Re: Melanoma Biopsy when almost 5yrs NED BC.

Something just occurred to me Jessica - if the surgeon cut part of the mole out during your mastectomy, shouldn't the tissue have been tested? If it was cancerous wouldn't it have caused it to reflect the margin wasn't clear? These might be things to ask about. Good luck!
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Old 05-26-2019, 12:26 PM   #4
Becky
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Re: Melanoma Biopsy when almost 5yrs NED BC.

Her2 in melanoma is very, very rare. There are some markers they test for but it is in the blood. LDH is the main one. However, the same kind of cell that makes bc is the same in melanoma. There are both from epithelial basal modified cells. Basal cell skin cancer is the same but is a different cell structure within the skin. I had 4 basal cell carcinoma removed about 4 years ago and get aggressively checked. Melanocytes are modified as they contain the melanin that gives the skin color and a tan.

Don't worry unless you have to. My daughter has had several melanoma scares with lesions being fully removed before they turned cancerous (if they ever would). This could be like those. Regardless, you know we are always here for you and to give support. I have been thru many Mohs procedures. Not fun but not bad. My daughter has been thru full blown surgery as well so we are here to give advise.

My biggest advice right now is even if it is nothing, get it removed anyway. It's a weird lesion and you should just make it be gone. I did this with one of my daughter's lesions and she was so td at me as it was in her hairline in the front and she had to get a small shave. But it was a nevus and those can go thru girations and turn bad over time sometimes
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 05-26-2019, 06:42 PM   #5
JessicaV
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Posts: 206
Re: Melanoma Biopsy when almost 5yrs NED BC.

Thanks for your kind support.
Becky, the biopsy removed all the lesion for testing, so it should be all gone, and they have enough for staging if it is malignant. If it is not melanoma, there shouldn't be anything left to morph into something bad; if it is, they will go in for a much bigger margin cut soon.

I have a good (brave) friend whose treatment for mycena gravis has stuffed her telemers and she pops out a few melanomas each year, which puts it into perspective somehow. She is doing another PhD while she's sick. Like you, she said "get it cut out, don't mess with melanomas."

The funny thing is that now I know I have lined up a good skin cancer surgeon/dermatologist, and a good GP I am feeling relatively happy and very much alive, and not scared, though I was terrified for so long with Breast Cancer. Not sure if this is because it is familiar territory, or because I am assuming it'll be ok until I know otherwise, or a naive confidence of having survived last time so thinking that means this monster can't/won't kill me. It is actually a surprisingly ok place to be. But I am a depth psychologist, so I have to ask myself whether maybe I am in denial, repressing anxiety and failing to really keep on top of the play because of this.
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Old 05-28-2019, 01:27 AM   #6
JessicaV
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Re: Melanoma Biopsy when almost 5yrs NED BC.

The biopsy results say it is a melanoma, but no invasive lesion, no ulceration, probably only dermis to epidermis junction. They are calling it early melanoma, possibly in situ, which I think sounds good. Still having wide-excision surgery Wednesday week to remove a wide margin. And then the pathology will give a conclusive verdict. But for now, I am happy that it isn't (apparently anyway) a lot worse
__________________
1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan
14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and
Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.

March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.
May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets.
Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.

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Old 05-28-2019, 11:45 AM   #7
Becky
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Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
Re: Melanoma Biopsy when almost 5yrs NED BC.

You lucked out and all will be fine.
__________________
Kind regards

Becky

Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia

NED 18 years!

Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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Old 05-29-2019, 02:49 PM   #8
tricia keegan
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Join Date: Nov 2005
Location: Ireland
Posts: 3,463
Re: Melanoma Biopsy when almost 5yrs NED BC.

Jessica it sounds like you had it removed early which is great.Like Becky I just had a Basal cell removed too and I do think there's a connection with skin and breast cancer.Good luck with the path report and I'm sure it'll be a good one.
__________________
Tricia
Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
2018 Mammo all clear, still NED!
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Old 05-30-2019, 12:57 PM   #9
donocco
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Posts: 474
Re: Melanoma Biopsy when almost 5yrs NED BC.

If you get a melanoma removed early it is close to 100% curable. Im not sure this applies to all cancers like they thought in the past. While ultraviolet light exposure is a factor in causing melanoma you can even get a melanoma between your toes and I doubt the web of the toe gets much UVL exposure.

Paul
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Old 06-12-2019, 07:12 PM   #10
Cathya
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Posts: 752
Re: Melanoma Biopsy when almost 5yrs NED BC.

Jessica;

One thing to tuck away is that immunotherapy works very well with melanoma. It sounds like you can pretty quickly put it behind you but it's always good to know. So glad you caught it early. Take care and all the very best.

Cathy
__________________
Cathy

Diagnosed Oct. 2004 3 cm ductal, lumpectomy Nov. 2004
Diagnosed Jan. 2005 tumor in supraclavicular node
Stage 3c, Grade 3, ER/PR+, Her2++
4 AC, 4 Taxol, Radiation, Arimidex, Actonel
Herceptin for 9 months until Muga dropped and heart enlarged
Restarting herceptin weekly after 4 months off
Stopped herceptin after four weekly treatments....score dropped to 41
Finished 6 years Arimidex
May 2015 diagnosed with ovarian cancer
Stage 1C
started 6 treatments of carboplatin/taxol
Genetic testing show BRCA1 VUS
Nice! My hair came back really curly. Hope it lasts lol. Well it didn't but I liked it so I'm now a perm lady
29 March 2018 Lung biopsy following chest CT showing tumours in pleura of left lung, waiting for results to the question bc or ovarian
April 20, 2018 BC mets confirmed, ER/PR+ now Her2-
Questions about the possibility of ovarian spread and mets to bones so will be tested and monitored for these.
To begin new drug Palbociclib (Ibrance) along with Letrozole May, 2018.
Genetic testing of ovarian tumour and this new lung met will take months.
To see geneticist to be retested for BRCA this week....still BRCA VUS
CA125 has declined from 359 to 12 as of Aug.23/18


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Old 12-09-2019, 01:14 PM   #11
JessicaV
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Posts: 206
Re: Melanoma Biopsy when almost 5yrs NED BC.

Well, the surgical cut to remove all last possible traces of a melanoma was about the same size as for my complete mastectomy: from my shoulder to my breastbone. And the tissue showed that the biopsy had removed every scrap of melanoma: no roots into the surrounding tissue. It got infected twice, IV antibiotics in hospital for 4 days each time. But now it is healed up and the scar is fading.
__________________
1997-2004 many cysts, many MG & U/S: polycystic breasts.
Sept 2013 found lump,Cyst?? forgot lump.
Dec 2013 GP check, Referred for U/S, MG,FNA.
7 Jan 2014 Radiology: Radiologist turned screen away from me. When asked she said "Not a cyst, very suspicious.See your GP asa results avail."
Cancelled my psych clients for the week.
8 Jan 14 GP: 2.2cm IDC in 6cm DCIS field. FNA=malignant cells. Referred to Surgeon.
Cancelled my psych clients for the month.
13 Jan
14 Surgeon said L mastectomy not lumpectomy, offered neoadjunctive trial, agreed adjunctive chemo after surgery a good choice for me. Booked Body scan and bone scan for staging (both fine) Surgery for16 Jan,
16 Jan 14 Surgeon also agreed in preop meeting to also remove 6cm fatty cyst in job lot. Good job done.
19 Jan 14 discharged home with 1 drain.
22 Jan 14 drain partly pulled out overnight, serious seroma (600 ml reducing removed every 2 days for a month) Serious staph infection because nurse said wait 3 days for yr surgeon appointment.
26Jan 14 pathology: 2.2cm Grade 3(3,3,2)ER-, PgR-, HER2+2 so to be confirmed by Sish test. Node negative. No vascular or lymphatic involvement. No metastases in scans.
30 Jan 14 HER2+ high amplification, 13 gene copies per cell.
21st Feb 14 Began 3wkly TCH adjuvant treatment at The Mount Hospital Perth, with 3monthly MUGA heart tests +Oncologist or Surgeon full physical check-up.
Cancelled my psych clients for 6 months.
Feb 14 First MUGA test: 71%,
First C15.3 test: 20
7th March 14 began Neulasta self-applied injections 24hrs after each TCH treatment. Bonepain helped by spa, heatpacks and
Claritin, reflux/indigestion helped by Somac.
July 14 completed docetaxol and carboplatin, ongoing herceptin to 12 months. Severe cognitive deficit/fatigue after 1pm daily.
Sept 14 Second MUGA test: 69%
Cancelled my psych clients for 2014
Dec 14 Third MUGA test: 70%
Second C15.3 test : 20
Cognitive fatigue delays return to work.

March 2015 Tachycardia pulse 168, night in hospital. Cardiologist says no heart disease, ALIVE ECG attachment for my mobile phone now regular monitoring.
July 2015 Worktrial, up to 8hrs per wk. Fatigue ongoing
Aug 2015 Heart good, no evidence of cancer, just Fatigue.
May 2019 Melanoma 1.5cm Stage 1 by right collarbone(was present as large freckle in 2014 and cut through by breast surgeon to remove fatty cyst at same time as mastectomy.) Melanoma removed leaving scar from shoulder to breastbone. In hospital twice for IV antibiotics. Told catagorically this could not be BC mets.
Dec 2019 Still NED, still fatigue in late afternoon, but have my brain back in the early mornings. So most days I watch the sunrise and hear the birds morning chorus in my bush backyard and am glad to be alive and to be me still.

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Old 12-09-2019, 02:07 PM   #12
jaykay
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Join Date: Oct 2012
Posts: 645
Re: Melanoma Biopsy when almost 5yrs NED BC.

Hi Jessica,

Sorry you had to go though the angst of another cancer. I also had a melanoma removed 3.5 years ago. I noticed it myself, my dermatologist did the biopsy and I was shocked to hear it was a melanoma (it couldn’t be anything simple like a basal cell or squamous, lol). It was on my chest but closer to my collarbone. I had a wide area excision as well and the initial biopsy had gotten everything. We are both lucky that it was caught early. Glad you are healing!

Janis
__________________
March, 2000: 48, Post menopausal (5 yrs HRT) Left breast, IDC 3mm/DCIS 1.6cm, ER+/PR-/Her2+++, mod differentiated, MIB low, lumpectomy, node neg via SNB, rads=33 Stage 1a
June, 2000: Tamox 4.5 years,Femara for 5 years (end in Jan. 2010)
Sept, 2012: 61, Via mamm, ultrasound, biopsy, right breast, 2.3cm tumor, ER+/PR-/Her2+++, poorly diff, KI67 60-70%
BRCA 1 and 2 negative
October, 2012: Bi Mast with tissue expanders, port placement
Final Path: IDC 2.8cm, DCIS, 1/4 sentinal nodes positive (@#$%). Stage IIB
Nov 29, 2012: Begin TCH/6x/every 3 wks, H for 1 year/every 3 weeks.
March 14, 2013: Finished chemo
April 9, 2013: Begin radiation 28x
May 22, 2013: Finished rads
June 1st, 2013: Started Aromasin for 5 yrs.
July 15, 2013: Switched to Letrozole (Femara). Probably for the rest of my life
October 16, 2013: Exchange surgery
October 31, 2013: Finished Herceptin
December 5, 2013: Port removed
Glad this year is over!
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