Will I ever know

[Oscar1]

About 2 months ago I had a small (2mm)lesion removed on my upper shoulder. Biopsy came back as Malignant melanoma in situ vs Dysplastic nevus with increased atypia and reincision RECOMMENDED. Had this done and 2nd biopsy report stated Ulceration with inflammatory cell curst formation. Trisected the speciman, and no evidence of residual melanocytic nest formation in sections.  I asked my derm if it was a melanoma or not and all he said is we will never know-could have been or could have been nothing. My gp says definitly not a melanoma because in the second biopsy it states nothing about any melanoma cells being found.
My problem is, now I am a mess about the whole thing. My derm doesn't understand why I am so upset he says it is done and over with, but I can't seem to let it go. I fear that every mole on my body is now a melanoma and spend every moment looking and inspecting them. I have never really inspected my body before this and now don't know if all of my moles have always been their, if they have changed etc.  Had 2 full body checks by 2 derms who say everything looks normal, yet I am still freaked out. Any feed back on your thoughts of the biopsy report would be greatly appreciated.  Also, I am 27 years old and seem to still be getting new moles. Are all new moles bad moles?

[Alan Rockoff, MD]

I understand your concern, but you are worrying far more than you need to.

Melanoma-in-situ is almost a melanoma, but not quite.  Pathologists often have trouble telling whether a small lesion like yours is that or a mole that's not quite even a melanoma-in-situ.  Either way, the thing has to come off, as yours did.  Your GP is not correct that the negative second biopsy tells you it wasn't melanoma, because the second biopsy shows only what was left after the biopsy, and all they found was scar tissue, which just means that the biopsy got it all.  This is a good thing.

Having one melanoma does not mean that all your other moles are melanomas or almost melanomas.  It is normal to get new moles till you're 40 or 50.

All you need to do is have your moles checked head-to-toe every 6 months.  You have already done this.  You do not need to have all your moles removed.  You may not need to have any removed, ever.

Now you need to deal with your anxiety.  Counseling and perhaps medication seem to me to be a good idea.  Once you get past this, you can get on with your life.  You're actually quite lucky that the doctor took off what you had at such an early stage.

Take care.

Dr. Rockoff

[MakaveliMOB]

you ll continue to get  new  moles until the age of 40 or so, not all moles are bad,and depending on where the mole is located, it can have varying degrees of atypia. There is a lot of research on this at  www.pubmed.com moles on  acral parts of the body have been known to have more atypia, probably because of consistant trauma, and inflammation.

So NO not all moles are bad. but always keep an eye out, a pass through scan of ur body, 1 time a month is enough, i think.