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Biopsy done for moles. Mole has regrown through the scar tissue. What are the chances of melanoma?

Jul 2012
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Practicing since : 1993
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First let me start out that I have really bad anxiety!

I had my yearly derm visit today and ther is one mole the doctor wants to do an excision on. I've used this dermatologist for 4 years and they've probably biopsied 10 moles, all by shave biopsy.

This particular mole that he wants to do the excision on, is a mole they did a shave biopsy on 2-3 years ago. Soon after I had the mole removed some pigment came back to it, and I remember being worried about it, but asking the doctor at the next visit that said it could come back since with the shave they don't cut the entire mole out.

On my appt last year the derm didn't say anything about removing it, looking bad, etc. Although I did have a physicians assistant last year who I hadn't seen before.

This mole has grown back through the scar tissue, it's flat, but very asymmetrical, lighter brown with some darker brown spots, it's on my leg, and has been growing slowly, I honestly didn't think of it as "scary" until the doctor said he wanted to remove it. This particular mole came back mildy abnormal (or whatever the wording is)

My questions are.. what are the chances this has turned into melanoma in the past 2-3 years after being "mildly abnormal".

Also, of course I'm scared of having melanoma but I'm more scared of having ADVANCED or metastatic melanoma. If this had been cancerous for 2-3 years, would it be having more symptoms by now (itching, bleeding, etc) or not neccessarily?

Please provide any information you have. My excision isn't until Monday and I'm freaking out.
Posted Tue, 28 Aug 2012 in Skin Cancer
Answered by Dr. Praveen Rodrigues 2 hours later

Greetings from Bangalore, India.

At the outset, we do not see much melanoma (but this is relative given our huge population) in these parts as opposed to other forms of skin cancer.

However, I have had the opportunity of working in the Gulf Region for the past decade & have seen numerous expatriates' largely from Australia, the U.S.A. & the UK & reviewed thousands of such moles so assure you of being in good hands.

Going by your uploaded image (albeit blurry); you seem to be fair-skinned & have a strong family history of melanomas. Relax. Not all melanomas are malignant or XXXXXXX

When a doctor says 'mildly abnormal', then he/she is being 'extra-careful' & given medical jurisprudence is big business in your parts, one empathizes with them. Firstly, I for one, am against 'shave biopsies' & feel they achieve nothing in particular either diagnostically or prognostically.

My recommendation is to completely excise this particular lesion 'in toto' with a 0.5 to 1 cm margin at the first instance & send it for histopathology. Then, Relax.the worst is over! Don’t sweat on this till way or the other, it has to be removed & believe me, it is not going to worsen till Monday morning!

That having said, think of the future....'prevention' is better than cure. Please avoid all 'tanning parlors’ & 'sun-bathing' & make sure you use an appropriate sunscreen with an SPF factor suited to your skin recommended by your dermatologist & remember to reapply it each 2-4 hours in 'daylight' hours or should you be exposed to ultraviolet light sources thereafter (eg disco strobe lights etc) & if you go swimming or sweat excessively or wash it off, please Re-Apply the same & carry one in your handbag as you do your mace ;-)

As regards your query if it had been cancerous, would there be 'more' symptoms, am afraid it does not quite work like that. I am sure you are well aware of all the symptoms of a developing melanoma by now & speculating excessively on this will not help either you or the implicated :) An 'advanced' stage will manifest with some systemic symptoms which you exhibit none of & I always believe that as in everything else in life, a 'happy' disposition does wonders to one's no means am I suggesting being flippant & not watchful, just balanced.

This is easier said/written than practiced & understand & empathize with your anxiety completely. Perhaps, you could confide in a good friend/mate/partner & take a small break & do something 'wild' & 'enjoyable' & 'pleasure-able' that can range from sky-diving to eating chocolate to what-have you tween now & Monday to put your mind at ease!

Hope this has given you a clearer picture & put your mind at ease & once again, do Not Worry. It just has to come off & all will be well!! Do keep me in the loop & wish you well.

Cheers. Dr Praveen Rodrigues MD Dermatologist, Cosmetologist & Venereologist, Bangalore, India.
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