melanoma maragin question

I was diagnosed with Stage 1 melanoma .4 mm thick at most, clean margins, it did go a little into the dermis, so it is not stage 0.   It was one piece. It was in the lower leg.  The dermatlogist did a dome shaped excision and left margins of .5 cemtimeters.  I know the usual standards for stage 1 melanoma is 1 centimeter, but the dermatlogist who works for a research academic institution as well said this surgery was sufficient. ( My lymph nodes came out fine on physical exam.  I am getting skin exams and mris and x-rays to look at the nodes, but they expect nothing.) Have you ever heard of someone with stage 1 melanoma like me  getting only .5 cm margins?  I really appreciate your help.

[Alan Rockoff, MD]

The usual recommendation is 1 cm margins, with 0.5 cm recommended for melanoma in situ, or melanoma which hasn't gone into the dermis at all.  It sounds like yours is on the border.  I would ask the dermatologist why he thought the lower level is appropriate in your case, and whether there is some anatomical reason not to do the larger excision.  You certainly have a small, thin lesion with a good prognosis, but if there's doubt and no special reason not to take more tissue just to be on the safe side, it seems reasonable to ask again, or to get another opinion.  A doctor can always go back and take a little more.  I would ask.

Best.

Dr. Rockoff