I'm 22 next week & have had numerous Melanoma scares. I've had surgery on my hand (severe atypia) & surgery on my stomach (mild atypia). Just got results back from a mole on my head & a mole on my lower back & they are both moderate atypia. My dermatologist said I have to have surgery on both. (All of this has happened in the past 3 months) I dont want to have surgery again if it isn't necessary. (the 2 previous surgeries came back with clear margins) Is surgery necessary for moderate atypical moles?
Is Surgery Necessary for Moderate Atypical Moles?
Doctor Answers 6
Atypical moles should be excised
It is good practice to excise atypical moles with clear margins. Atypical cells that may be left in the skin can can develop to malignancy.
Would Recommend Surgery
Virtually all dermatologists would recommend obtaining clear margins with severely atypical nevi. It is a bit more controversial with moderate atypia. However, I feel it is not worth taking a chance and these should be excised as well. You do not want to leave atypical cells behind. Also, it gives extra insurance in case your slide was "under-read" by the pathologist. You might look into your family history for melanomas and some of the cancers which are genetically linked, such as pancreatic cancer. Some of us also are sending our patients such as yourself for Mole Mapping.
Atypical mole removal
A mole classified as atypical requires removal with clean surgical margins. In thus economy, I am seeing more patients who have delayed surgery for financial reasons only to present with enlarging, cancerous lesions. Particularly for individuals having the propensity for atypia, surgery is important. Twenty years ago, my melanoma practice was small but I now see melanomas literally on a weekly basis. Melanoma can be deadly so I would encourage you to have atypical lesions treated promptly and completely.
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Must atypical moles be removed?
Any atypical pigmented lesion should be removed with a clear margin. Anything less may leave cell that have the potential to become malignant.
Atypical moles should be removed.
If a mole has been diagnosed pathologically as atypical, whether moderate or severe, it definitely should be removed - and totally with clear margins. The findings indicate an abnormality that can ultimately progress to a melanoma which can be lethal. An atypical mole is not lethal.
You should have fairly close follow up with your dermatologist who can screen for these atypical moles or even for a potential melanoma. It is better to trade off multiple scars and live then miss a melanoma and not be so lucky.
Atypical moles should be removed
1. An atypical mole means that there are cells that are in some way not normal in that mole
2. A abnormal skin cell has a higher chance of potentially become a skin cancer
3. It is generally considered good practice to remove atypical moles
4. As a plastic surgeon I have removed many of these lesions on the face and body. With the proper techniques and post operative regimens there is a good chance of getting excellent healing and an inconspicuous scar.