Melanoma?

[madcon]

I am a 33 year old mother of two who is very concerned about two lesions I recently had biopsied.  The first was on the underside of my upper arm.  It looked like a freckle--and I do have quite a few freckles despite my dark hair and eyes--but only darker.  It was approx. 2 mm. in size and looked like it was comprised of several small, dark dots.  I wouldn't say it was brown with dots, but more just a bunch of dark dots close together.  My doctor said it looked very superficial (and it did--it looked like it was lightly tatooed on) and probably wasn't anything, but he wanted to biopsy it to be sure.  My concern is that it was darker than my other "freckles".  The borders were somewhat odd too--but I must say not too different from my other freckles.  I am unsure how long it was on my arm.

The second spot was also about 2 mm in size and on my foot (inside my foot).  It has been there for awhile and hasn't really seemed to change much.  It did have some darker pigmentation in it though, which prompted the removal.  Initally the Dr. was going to just watch that one, but I insisted it be removed.  Both were removed by a shave biopsy.

My questions for you are (1) do these sound like melanoma (I know you cannot diagnose on the internet, but how concerned should I be?)  (2) can a doctor tell how deep melanoma might be?  My doctor felt these were both very superficial and that if they were anything serious that they were caught early.  How can he know that?  (3) how long do biopsy results take?  It has been 3 days now and when I called to badger the doctor this afternoon the office was closed.  Not happy about that as I now have to stress all weekend long.  And finally (4) I recently had a complete blood work up that came out completely fine--would that show any abnormalities if in fact either lesion was cancer and it has spread?

Thank you in advance for your time and consideration.  I am very scared right now and appreciate any insight you can give me!

[Alan Rockoff, MD]

Neither of these sounds like a melanoma.  Both do sound superficial, and in any case the pathologist will be able to tell that definitively.  I expect you'll have the pathology report back by tomorrow, so your worrying should be over by then.

Take care.

Dr. Rockoff

[suntower]

Hi Madcon,

I'm not a doctor but since it's the weekend and I'm not sure the doctor will respond before Monday, I just wanted to chime in and let you know that I know how you feel. I've got two little ones and I recently went through a couple of biopsies that had me completely beside myself with anxiety during the wait period. I had myself convinced that I was going to die, to be honest, which is so terrifying now that I have kids. So I understand your fear, but at the same time, as someone who has come through the process 'clean' and as someone who obsessively researched melanoma during my scare, I can tell you a few things that will hopefully at least partially relieve some anxiety.

First, from my admittedly non-doctor knowledge, neither of what you describe strike me as likely melanomas. There are plenty of 'unusual' moles and/or freckles that are simply that...unusual. The tendency to assume the worst is understandable, but one thing I've come to learn is that the odds are GREATLY in your favor that these are not melanoma, but just unusual moles or skin lesions. The fact that they don't seem to have changed much (at least the foot one, you didn't say much about the arm one in terms of change) and they are small just reduces the odds of melanoma much further. So imagine trying to guess a number between 1 and 10000 drawn out of a hat...almost impossible, but that's probably somewhere around your risk considering what you've described.

Second, yes, I think a doctor would be able to make an educated estimation about depth. Not an absolute declaration, but a pretty good estimate. An apparent lack of concern by the doctor is usually due to a legitimate opinion of the doctor about the seriousness of the situation. There are various characteristics of more advanced melanoma that you don't describe that indicate that, in the rare chance it was melanoma, it would be early (i.e. small size, subtle abnormalities, no bleeding, little to no change). Again, benign moles/skin lesions with multiple colors, irregular borders, etc. are not uncommon (dysplastic nevus?)...in the absence of notable change over time they are likely just benign, although of course it can't hurt to remove them to be safe if you're not worried about scars.

Third, I believe biopsies can take anywhere from 24hr to 10 days, depending on the lab and the doctor. It stinks to wait...it can be tortuous but for whatever reason sometimes these places really seem to take their time.

Again, I'm no doctor, so if the doc comes on here he'll obviously be the one with the most dependable info, but I expect he'll tell you that your worry, while understandable, is not really in proportion to your risk, at all. As an outside observer who has been through the biopsy scare, I can tell you that the odds are greatly in your favor that these are nothing more than benign skin lesions. If I didn't feel that was the case, I wouldn't have responded, but knowing how stressful it can be, I wanted to at least try to put your mind at ease somewhat. I think you'll be fine!

-Kevin

[madcon]

Thank you for your very kind words.  I know what you are saying is true and that the odds are in my favor, but I am still very frightened.  The thought of something happening to me--or to my family just terrifies me--especially now that I have young kids.  I am so happy to hear that your ordeal is over and that you got good results.  The waiting game is the worst--it is driving me crazy!

Your message made me feel much better--so thank you for taking the time to help me out.  I am very grateful!  I will post as soon as I get my results too.

Thank you!!!
Rebecca

[stressedaboutskin]

Hi Rebecca,
I am 34 yrs old, and also a mother of 2 littleo ones.  I had 2 biopsied moles 4 yrs ago when my oldest child was only 13 months old, so I can relate to your worry.  My biopsy results took about 1 1/2 weeks to come back, but I have to wonder if the longer it takes the better the news.  My friend had a melanoma on her face a couple of years ago, and her results came back 4 days later.
Once again, I have a lesion that I am concerned about and will be going to see a dermatologist in 2 weeks so I am again doing the worrying game.....convinced I am dying of cancer:(  I suspect you are likely much like me, and spending a lot of time googling Melanoma and scaring yourself half to death?  I guess the internet is a double edged sword........if it wasn't for it, I probably wouldn't have a clue what Melanoma was and wouldn't notice one on my skin if it right in front of me, but on the flip side, it makes you somewhat paranoid.  
Try not to worry too much.  It is likely nothing at all, and if on the off chance that it were a Melanoma, I would think that it would be VERY early and superficial if it is only 2mm, and then you can thank your lucky stars that you were diligent enough to catch it early enough
Take care:)

[stressedaboutskin]

I forgot to mention in my previous post that those 2 biopsies that I had done 4 yrs ago both came back as benign;)