Abnormal mole cells

I have been seeing a dermotologist annually for the past three years after my primary care physician noticed some questionable looking moles.  I have had six removed (two recently).  Of the first four, three were perfectly fine and the fourth had abnormal cells.  The surrounding area was excised and the lab report came back normal.

The recent visit yielded two small moles, one on each shoulder being removed.  Both came back with abnormal cells.  I was told the cells were not melanoma, but the surrounding area needs to be excised.  This will be done in about two months.

My questions are, what specifically are abnormal cells?  I was told they can be pre-cancerous.  Would they definately grow into cancerous cells?  How long would that take?  Would you be able to  let me (and this board) some details about moles and abnormal cells?

Is the excising of the surrounding area precautionary to ensure no other problems, or is there a good chance the abnormal cells may have spread?

Thanks for your comments.

[Alan Rockoff, MD]

Good questions.  The usual medical term for abnormal cells is, "dysplastic."  Basically, this means that the cells or their arrangement look "funny" to the examining pathologist.  How funny is funny is pretty subjective, so there is a lot of disagreement among pathologists.  Skin pathologists are more experienced at looking at moles, and have a better sense than general pathologists about what the spectrum of normal is.  (What kind read your slides?)  Pathologists cosnider abnormal moles on a spectrum--from mild to severe, depending on how funny they look.

But here's the point: funny moles are NOT cancer.  (There's a pretty sharp line, and if the call is close, treatment is not just to take a little more off, but to treat it as if it were a cnacer.)  We don't know if they will ever turn into cancer--it just sems a safer bet to take a bit more off, just in case.  It's a common situation, and most doctors don't consider such moles "pre-cancerous" in any meaningful sense.

Sounds like you're fine.  You might ask your skin docotr for clarification as to how "abnormal" the cells were.  You might also get another skin doctor's opinion, just for better reassurance.

Best.

Dr. Rockoff