Mild to Moderate Atypical Mole Removal. I Am Scared I Will Develop Melanoma?

Question

I had a mole removed last week and they called to say I have to have to meet with the plastic surgeon to have it completely removed. They said on the phone it was mild to moderate. I am freaking out and worried that this means I would most likely develop melanoma in this spot or somewhere else in the future for certain. Is this a bad one mild to moderate? I have to wait 3 weeks for the appointment and am freaking out. Thanks

Jay S. Gottlieb, DO · Answer

Nevi (moles) do not go from being normal to being cancer. Typically they will go through stages of change called dysplasia. A normal mole can change into a mildly dysplastic mole and then may progress. If it does, it will go on to being moderately dysplastic and proceed to severely dysplastic. Just because a mole has made one or two changes does not mean that it will keep going to a more severe stage. The problem is that we can not predict with certainty which one will stay at a given stage and which one will continue to get more dysplastic. It is for this reason that when we see a dysplastic mole, we elect to remove all of the cells by excising it. It is a relatively simple and painless procedure. Severely dysplastic nevi can go on to become melanoma, so it is important to get this mole removed and then have yearly full body skin evaluation with a board-certified dermatologist. Use SPF 30 and be sun smart and get your yearly check-up and you should be fine.

Philip Young, MD · Answer

This is quite common and the time frame that you mentioned is okay to wait. Just make sure to have the surgeon to take significant margins. I would say 3mm would be good. If it were a melanoma I would consider larger margins with pathological guidance in the operating room or a MOHs type of approach.

Martie Gidon, MD, FRCPC, FAAD · Answer

Mild to moderate atypical moles are quite common so you do not need to panic. The rest of the mole should be removed, but it is not urgent and there is no problem waiting a month. You should monitor your skin for any changes in your moles, have regular skin examinations with your dermatologist and use sun protection.

Samir Shureih, MD · Answer

It is the responsibility of the Doctor who performed the biobsy to sit down with you and explain the results of the pathology report and the recommendations.

	Since we do not have the advantage of seeing the pathology report we can not give you proper advise

Mitchell Schwartz, MD - Account Suspended · Answer

Atypical moles are precancerous growths that are cured when completely removed. In our office, we will do an excision to get clear margins for all moles that have moderate to severe atypia. For a mildly atypical mole we will observe the area and, if any pigmentation recurs in the biopsy site in the future, a very small excision is done (often with a small punch biopsy tool) for a minimal scar. We also follow all of our "atypical mole" patients by doing full skin examinations every six months. Depending on their size and location, atypical moles can be easily removed by one of two methods. One is a "shave excision" where the mole is actually "shaved off" at a level just below the surface of the skin. The other is an excision with suture closure which uses both dissolving and non-dissolving sutures to give the best cosmetic result. Dermatologic surgeons, not plastic surgeons, typically do both procedures expertly and can decide which would be best for your particular mole. I recommend you see a board certified dermatologist for both your surgery options as well as your follow-up examinations twice yearly.

Mild to Moderate Atypical Mole Removal. I Am Scared I Will Develop Melanoma?

Answers (5)

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