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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do excision biopsies show melanoma?

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8009 Questions

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Posted on Fri, 8 Jun 2018 in Skin Hair and Nails
Question: I had a shave biopsy and the report is below. The doctor said this is not melanoma but I am worried. She recommended a deeper shave but I chose an excision because I wanted the mole removed completely. I am waiting on the excision biopsy and am nervous. What are the chances the excision biopsy will show melanoma? How accurate are shave biopsies?

The full report says the findings are most consistent with an atypical combined nevus variant displaying nevoid and atypical epitheloid cell components. A rare dermal mitosis is noted in the latter cellular population. The area of scarring is consistent with prior irritation or trauma. Nonetheless, the intradermal component extends to teh base. The lateral edges are uninvolved. Reexcision to ensure complete removal is suggested. Multiple levels have been examined. THe majority of melanocytes within the dermis are arranged as orderly nests and cords with nevocellular features.
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Answered by Dr. Kakkar S. 41 minutes later
Brief Answer:
Regarding dysplastic nevus

Detailed Answer:
Hello. Thank you.
I am Dr. Kakkar (Dermatologist and Venereologist). I have noted your concern and I have gone through your biopsy report.

The chances are extremely slim that the excision biopsy would turn out to be a melanoma. Shave biopsy suggests mild dysplasia/atypicality.

Moreover, the lateral edges were clear, however, the deeper margin needed to be either reshaved or excised for it to be clear. A deeper shave would have been equally good as an excision. It is a well-known fact that most dysplastic nevi never turn into a melanoma.

More important factor for having a higher risk for melanoma is if someone has a large number of clinically dysplastic nevi(>5 dysplastic nevi). Having a single dysplastic nevus does not increase the underlying risk of developing melanoma.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Kakkar S. 54 minutes later
Thanks for your response. That is what my dermatologist said, but I am still very nervous. I hardly have any moles or freckles although I am fair skinned. I have one mole on my arm that I had tested a year ago that was a common mole. I have a few other freckles/small looking normal moles, but no other odd looking ones and no family history of melanoma. I also have not spent much time in the sun...never sunbathed, etc. Never been to a tanning bed ever. Hopefully it won't turn out bad. Are atypical moles bad/dangerous on their own?
doctor
Answered by Dr. Kakkar S. 19 minutes later
Brief Answer:
Regarding atypical moles

Detailed Answer:
Hi.

As I said, most atypical moles never turn into a melanoma. It is quite normal and common to have 1 or 2 atypical moles and they don't usually turn into a cancer. Only if they are present in more numbers (more than 5) e.g in Familial Atypical multiple Mole Melanoma Syndrome (FAMMM) should one have a higher risk of melanoma.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kakkar S. 14 minutes later
So, does the shave biopsy usually have accurate results to diagnose if the mole is melanoma or not?
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Answered by Dr. Kakkar S. 21 hours later
Brief Answer:
Regarding dysplastic nevus

Detailed Answer:
Hi.

Yes, as long as the shaved tissue includes most of the nevus that needed to be removed so that the whole of it including the margins can be scanned.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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