Melanoma Biopsy when almost 5yrs NED BC.

[JessicaV]

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?

[Lucy]

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.

[Lucy]

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!

[Becky]

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

[JessicaV]

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.

[JessicaV]

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

[Becky]

You lucked out and all will be fine.

[tricia keegan]

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.

[donocco]

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

[Cathya]

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

[JessicaV]

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.

[jaykay]

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