A small mole on my cheek was determined to be a melanocyte of moderate atypia. The dermatologist recommended that the rest be removed with a 2-3mm margin. Does it REALLT need to be removed when it will result in a scarring to my face? Are there alternatives for treatment that are not as invasive as excision? Can I treat it conservatively now and have it excised in a year or two (call me shallow, but can I deal with the scar after I get married)? Can the pathology be misread, can it be retested?
Does a Facial Mole Which Was Determined by a Biopsy to Be a "Melanocyte of Moderate Atypia" Really Need to Be Removed?
Doctor Answers 2
Mole with moderate atypia does it really need to be removed
Absolutely in my opinion. You may even want to consider taking more margins. A scar is better than getting cancer spread throughout your body. Melanoma also is one of the worst cancers you can get. Not to scare you but I really want you to understand that. One study showed that 5 mm margins for skin cancers removed high 90 percentage of the cancer. 4mm was lower 90's and 3mm was in the high 80s. I would ask to have 5mm margins and get this done with a moh's surgeon to make sure all of it is gone. They will take finer slices of the specimen to make sure there is no cancer or bad cells in the margins.
Treatment for a moderately atypical mole
In our office, we will do an excision with suture closure to get clear margins for all moles that have moderate to severe atypia. Since these are considered to be precancerous moles they do need to be removed. Your mole should be removed by excising a simple ellipse of skin and then use a "layer closure" with both dissolving and non-dissolving sutures to give the best cosmetic result. The area then typically heals with a small, linear scar that is hardly visible. It makes sense to have it removed now for safety's sake and then the scar will have more time to heal and improve before your marriage. You can certainly request that your biopsy be read by another pathologist for a second opinion. Make sure that it is read by a pathologist that is board certified in dermatopathology.
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