Should a Mole That Has Mild to Moderate Cells Be Removed or Watched?

Should a Mole That Has Mild to Moderate Cells Be Removed or Watched?

Doctor Answers 7

Moderate Atypia in Moles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
If an atypical mole has been biopsied and shows that some of the mole cells remain, the most conservative approach is to excise the area to get "negative margins". Of course, if the mole is in a difficult area, or the patient does not want another procedure, clinically monitoring the area is crucial.

Arlington Dermatologic Surgeon

If a mole is changing, get it removed. It could save your life.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sometimes small changes in shape and color of a mole, or the way a mole feels, can be an early sign of malignant changes in a mole.  The safest thing to do to see a good dermatologist, have the mole examined and removed if there is any concern.

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

How to treat moles with atypia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The only way to know if a mole has atypia is by removing it and sending it to a dermatopathologist for examination. So I assume that is what was done.  When a mole is removed, it should be removed in its entirety so that the pathologist can examine all the margins, including the edges and the deep portion.  If a mole, let's say, is shaved off the surface, normally that does not allow for examination of the deep margin and an appropriate diagnosis cannot be made.

In my practice if a mole is moderately atypical and there is still some remaining in the skin, I recommend a reexcision with conservative margins to make sure the rest of the mole is removed.  For a mildly atypical mole, I recommend observation for recurrence.  If it recurs, then a reexcision is done.

Emily Altman, MD
Short Hills Dermatologic Surgeon

You might also like...

How to Treat Atypical Moles

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In my office, we will do an excision with suture closure to get clear margins for all moles that have moderate to severe atypia. Far 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. I recommend you see a board certified dermatologist for both your surgery options as well as your follow-up examinations twice yearly.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Moles with atypia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Moles with atypia fall along a spectrum of benign to melanoma. Mild atypia falls closer to benign while the moderate to severe  are closer to melanoma.  That being said, they are atypical and not normal and no one can tell you whether a mole with atypia will become a melanoma in the near or distant future. Conservative patients and their doctors will excise mild atypia. Some patients and their doctors will simply follow clinically the mild to moderate atypia, while almost all dermatologists will agree that severe atypia requires removal with clear margins. This decision comes down to the patient, the type of atypia and the ability to follow closely any changes in the mole. Your family history and prior history of any melanoma will also be critical in deciding how to proceed. Although this is a grey area for sure, your dermatologist will be the one who can best advise you how to proceed and any decisions should be made by you and your dermatologist.

Shawn Allen, MD
Boulder Dermatologist

Atypical celluar mole

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Any mole that has atypical cells on biopsy should be removed. Cellular atypithy with time will become either precancerous or frank cancer; there is simply no advantage to leaving it present.

Atypical mole treatment

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

For moles with minimal to moderate atypia, careful clinical observation may be performed. However, whenever  atypia is in the moderate spectrum, excision with sutured reconstruction may offer an excellent cosmetic outcome while giving you the peace of mind that the abnormality is removed completely. Excised specimen should be sent to a dermatopathologist for an evaluation to confirm that the lesion was removed and that no further abnormality, such as melanoma, was present.

Larisa Ravitskiy, MD
Columbus Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.