Bad biopsy results for melanoma: How to get a second opinion?

@tillymack
I have had this type of procedure 2 times at my dermatologist’s office. I go annually for a skin scan as I have many dark moles. My moles removed were on my left outer upper arm and the other on the right side of my chest under my arm. I have had no issues arise after the full excisions. I also have a family history of cancers, including skin cancer. I have had a micro cancer found in my thyroid.

You can get 2nd and 3rd opinions, depending on your insurance. Do your research on melanoma specialists to have them do the full excision and to determine if additional treatments would be needed in the future and how best to monitor due to your family history. You are definitely at a higher risk for melanoma and should get special attention.

Thanks for your reply! How would you recommend I find a melanoma specialist? It is difficult since my dermatologist is referring me to someone within her group who does not appear to be a melanoma specialist per se but the dermatologist within her group who does the full excisions. I have sent the required documentation (pathology report and photo) to a well regarded academic specialty program but the process is for me to wait to be evaluated and offered an appointment if accepted. I'm concerned I will not be accepted since I do not have a diagnosis of melanoma just the scary lentiginous junctional nevus with severe melanocytic dysplasia with a note that due to the degree of melanocytic dysplasia, complete excision is recommended in order to ensure complete removal.

@tillymack
You may want to call medical offices that treat melanoma cancer to ask for referrals to/recommendations of dermatologists they work with for precancerous mole removal that may be a risk of turning into melanoma due to biopsy result and family history risk. The sooner you have the irregular/abnormal mole/cells removed, the better. Leaving them can turn it into melanoma.
1.
https://www.mayoclinic.org/diseases-conditions/moles/diagnosis-treatment/drc-20375204
2. https://www.aimatmelanoma.org/melanoma-learning-center/find-a-melanoma-specialist/
3. https://resources.healthgrades.com/right-care/melanoma/finding-the-right-doctor-for-melanoma-treatment
4. https://www.cancer.org/cancer/types/melanoma-skin-cancer/causes-risks-prevention/prevention.html
5. https://www.aimatmelanoma.org/melanoma-101/how-melanoma-is-diagnosed/health-professionals-you-might-see/
6. https://skincancer-specialists.com/skin-condition/how-to-avoid-melanoma-a-complete-guide-to-protecting-your-skin/
7. https://www.curemelanoma.org/patient-eng/ten-tips-for-people-just-diagnosed-with-melanoma/choosing-your-doctor
8. https://www.hopkinsmedicine.org/kimmel-cancer-center/cancers-we-treat/melanoma/prevention-diagnosis
9. https://skincancer-specialists.com/skin-condition/the-ultimate-guide-to-understanding-melanoma/

@tillymack If I were in your shoes, I would first call to insurance to see if they will cover a second opinion. Then reach out to a local cancer center and request information on a melanoma expert within their areas.

When my melanoma was diagnosed, it was because I had to push for a biopsy. Four different doctors told me, "it's nothing to worry about" without doing a biopsy. In your situation, given family history, it's important this be addressed sooner rather than later, I would think! It might look like an unusual mole, but could be more. Safe rather than sorry. And don't be afraid to ask at your dermatologist's office if the practitioner they want to use has experience with this type of procedure!
Ginger

Thanks so much for your very helpful links!

I was diagnosed by a local dermatologist in the San Fernando Valley who referred me to a plastic surgeon friend of his for the surgery. My wife warned me to go to a melanoma specialist. I didn't and it turned out that the plastic surgeon didn't take a wide enough margin around the lesion. The hospital asked for a second pathology opinion and they pointed that out. I then listened to my wife and she made me go to an oncological surgeon that had performed an adrenalectomy on her a few months prior. He was at the John Wayne Cancer institute in Santa Monica. They did a lot of preparation, and I had a second surgery a month after the first. I was then in a clinical trial for the next six years. It's now 33 years later and I've had no recurrences. Unfortunately, I've had two nieces that have had melanomas and one of them is undergoing immunotherapy at the moment.

Thanks so much for your reply. It's great to hear that the inadequate margins were noted and you were treated successfully although with some delay. I can relate to your experience on several levels. My father was also referred to a local plastic surgeon rather than seeking care at nearby Memorial Sloan Kettering. I remember some question about margins. He did not survive beyond 5 years.
I noticed just today that the dermatology practice where my biopsy was performed includes two dermatologists labeled on the mast head as surgical dermatology while the dermatologist I was referred to for full excision is labelled general dermatolgy. Perhaps because they are trained in Mohs surgery and that is not required in my case...

@tillymack, if you'd like to seek a second opinion with Mayo Clinic experts, you can submit a request here: http://mayocl.in/1mtmR63

How are you doing?

I'm well, thank you!