queetion about dysplastic nevi

[katy88]

Hi, I am wondering if you could give me some clarification about having having nevi removed. I am a 30 year female  plagued with lots of nevi.( family members with multiple nevi, no melanoma) I have had approx 9 removed over a 15 year period. The nevi removed had not had any problems except for the one removed a year ago that came back dysplastic and then waiting on results of two removed two weeks ago. The one I did have removed that came back dsyplastic a year ago, I had a plastic surgeon remove it for me and he did a small excison with stitches. I thought nothing more of it except I knew I needed to be more careful because it had shown what he described as changes. Two weeks ago I had an exam by a dermatologist who decided to remove two moles because he could not tell for sure if they were alright. He shaved them off and sent them for pathology. I have never had moles shaved just excised by a plastic surgeon. (I was always referred by my GP to a plastic surgeon due to the lengthy wait for a dermatologist in the area I lived before). What concerns me is that at the end of the appointment the dermatologist told me that he would call and let me know the results and if I need to come back in and have more skin excised. This made me a bit worried when I got home and thought of what he told me. When a person has a mole shaved and it comes back dysplastic(whether it be mild to severe), it that why more tissue would be taken so there is not any remaining  mole tissue that may eventually turn cancerous? Or does it mean that he if he tells me I need more excised that I definitely do have melanoma? He told me he did not think it was melanoma but said they need to be biopsied to make sure. Thanks for you time and patience.

[Alan Rockoff, MD]

Many times pathologists tell us that the mole we biopsied was not cancerous but showed some mild dysplastic changes.  In fact, no one knows whether these changes would lead to something worse or not even if the mole was left intact.  But since we don't know, we take off a little more just to be sure there's nothing to watch.  I'm sure that's all your dermatologist meant.  Having to take a bit more off does not mean you have cancer.  The rather vague term "dysplastic" does not necessarily mean a step on the way to something more dangerous.

Best.

Dr. Rockoff

[katy88]

Thank you Dr. Rockoff for your response. I appreciate the clarity on the subject.