Maligant Melanoma diagnosed, SLNB failed - no LN biopsied- now what??

[VegasAly]

I had a mole removed 1/12/09 that came back as...

malignant melanoma, superficial spreading type, 1.0mm of Breslow thickness, Clark Level of III/IV, margins clear (peripheral - 4.0mm, deep - widely clear
Comments-
1) the lesion is asymmetrical and poorly circumscribed; 2) confluent nests of melanocytes are distributed unevenly across the front of this lesion; 3) distribution of melanocytes, lymphocytes, pigmnet, and rate ridges is uneven; 4) in some high power fields, solitary melanocytes are predominant over nests and they are pagetoid in foci; 5) there is absence of maturation in the central perotion melanocytic lesion


Was referred to a oncology surgeon who recommended a Sentinel Lymph Node Biopsy and radical excision of the original mole location.

Had surgery for SLNB and radical excision on 2/11/09. Surgeon went in for a lymph node but came out with fat cells....

Lymph node biopsy: fibroadipose tissue with no evidence of lymph node on multiple levels
Wide Excision: no evidence of residual melanoma, lateral and deep margins negative for tumor

At surgery follow up appointment, surgeon said to come back in 3 months for him to keep an eye on my lymph nodes.

I'm wondering if there are any other tests to run to get an idea if the cancer did get into the lymph nodes, or if a conservative approach of wait and see is smarter than a more aggressive approach. My 30th birthday is 2 months out and trying to figure out how serious my case is and if I should be pushing for more aggressiveness on the doctors part or if from the pathology reports, if it's an okay approach to keep up with quarterly follow ups for skin and lymph nodes and feel optimistic that cancer isn't going wild undiagnosed and unchecked.

[VegasAly]

Thank you for the responses.
I was awake while a radio tracer was injected and watched as it moved around and show some directional movement toward me left shoulder. As well, I was told a blue dye was used once I was under to show the lymph node as well. The Dr said he thought he had finally found a lymph node, but it turned out to be fat cells.

I will try not to hold my breath for the next 12 months to 5 years but I wonder what symptoms would show up if something where to come of it? I feel around under my armpits every day or so trying to make a mental picture so if a small lump of something hard does develop, I'll know it but not sure if that is even that I should be keeping an eye on. Waiting for a follow up meeting with the medical oncologist but insurance company is taking their time in approving the consult so not sure how long until my questions will be answered.

[Pum]

A good friend of mine had a very similar diagnosis to you. In her case there is no treatment after the surgery and she has been told to enjoy life. Nothing more may ever come of it, or not, it's a luck of the draw thing. She understands the first year is the most likely time to see a re-occurrance and she also has 3 monthly checks. Her one year is coming up soon and so far so good.

Take care.

[Lind47]

Did you have a needle loc done before the SLNB?  They use a radioactive tracer that helps in identifying where the SLN is located, Typically that is the first node that cancer will spread to, ask your physcian about this?