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Sentinel Node Biopsy Timing

Sentinel Node Biopsy Timing

Posted By
adriana cooper
1/12/2020 10:14pm
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Replies: 3

Giving advice to a newly diagnosed young 21yo lady. (Melanoma needs to stop $@%&*)

I know that older theory was that it should be performed at time of WLE.

https://melanoma.org/legacy/find-support/patient-community/mpip-melanoma...

But I have run across this.

http://www.biomedsearch.com/nih/time-from-diagnostic-excision-biopsy/121...

Is waiting preferred now??

The advice I have provided thus far
"I am sorry to hear about your melanoma diagnosis. Rest assured your future is long and bright. As I may have mentioned to you when we met previously, I have gained a great deal of experience regarding melanoma during my wife's 5+ year journey. As I understand it you have only just had a biopsy (hopefully a punch rather than a shave) and related pathology results. You are at an important point as to your next steps which are very important to proper staging and your available treatment options. Realize that although it may feel like doing something right away is important a few days and even weeks delay make no difference at this point. What is most important is that you take the proper steps with the most educated people so as to get the proper staging which will allow you to get the most current and advanced treatment available. I understand that you have some kind of appointment on Monday, please do not let them cut on you unless they are a melanoma specialist or a surgical oncologist specializing in melanoma. THIS IS VERY IMPORTANT. Very often general practitioners and dermatologists try to cut it out and destroy any chance at getting the proper margins and do not take the proper steps to know the proper depth and mitotic rate which are some of the important factors in staging. A discussion about performing a Sentinel Node Biopsy at this point needs to happen right now as it needs to be done just prior to any wide local excision (cutting it out) and is crucial in proper staging.

I am happy to have a discussion with you and your loved ones at any time. I urge you to refrain from general internet searches about melanoma as there is a lot of outdated and inaccurate information. If you do want to do some research I would recommend starting with melanoma.org which provided us a great deal of support and knowledge. It is important to know that you (and and your loved ones) are your best and most important advocate. Doctors don't know everything (even neuro-oncologist's and melanoma specialists.) Your life is more important to you than anyone else.

Here to help in anyway I can"

Best wishes to all
Thanks Rob

Adriana

Here is a video from Aim at melanoma that goes into detailed current thinking and second link to new staging 8th edition document that came out two years ago. https://m.youtube.com/watch?v=4vNP49dJGVk&list=PLOnM_erAQqIBK-ASSZujKruJ.... https://cancerstaging.org/CSE/Physician/Documents/Melanoma%202.2.18.pdf

tkoss - (1/19/2020 - 10:03am)

I will describe my experience, since I am at nearly same stage. I had a biopsy Nov 2019 . shallow or small melanoma, excised. Case closed. Then on a 6 moth follow up the Dermatologist found a bigger, badder mole. Hence WLE and SLNB. so from that biopsy and confirmation of Stage 3c melanoma to 1st infusion it has been about 2-1/2 months/

If Dermatologist did not find a bigger, badder mole , about 1" away from the biopsy site at time of first biopsy, concluding it was not overlooked, then an undetectable mole blew up to Stage 3C in a matter of a few 3-6 months. So a lot can happen in 2-1/2 months.

so timing in my mind is extremely critical.

based on delay from prescription of monotherapy to actual getting my first infusion, the industry doesn't seem to be in an all- fired hurry. They say that in fact.

I don't actually believe foot dragging such that the cancer spreads more benefits the patient.

tkoss - (1/21/2020 - 5:48am)

to clarify, first biopsy Nov. 2018 not 2019. then for reasons of insurance I didn't get issue resolved until March 2019. Melanoma confined to mole.
At 6 month follow up Derm found another mole and this one became Stage 3c. So from observation of suspicious mole in October 2019 to 1st infusion Jan 2020 it was about 4 months..