It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....

Cancer: Skin Message Board

Is a punch biopsy good to take out a mildly atypical mole?

Post New Thread   Closed Thread
LinkBack Thread Tools Search this Thread
Old 11-17-2011, 02:23 PM   #1
Join Date: Nov 2011
Location: California
Posts: 5
hkwak002 HB User
Is a punch biopsy good to take out a mildly atypical mole?

I had a few shave biopsies done to take out a few moles. Two came back as mildly atypical. These are my first. So the PA said they would do a punch biopsy next time to take the surrounding area/left over cells out. I told her I wanted to do an excision but she said it was not necessary. I don't see any visible mole left but obviously there are cells left. I asked online on this site where doctors reply to your question. A plastic surgeon said that I absolutely need to have a plastic surgeon to do a full excision and telling me how the PA could not be more wrong and doing a shave and punch will mess up the diagnosing of melanoma. There was no melanoma found first of all and it was mildly atypical. I've already done the shaves so can't do anything about that so I'm just wondering if a punch biopsy is good enough of a precautionary measure to make sure these moles don't come back or turn into something bad. Should I push for an excision or should a punch biopsy be enough to take out the surrounding area for clear margins?

Also how likely is it that the pathologist made a mistake in the diagnosing? I mean the difference between melanoma and mildly atypical is big. If it was severely atypical to melanoma I understand. I mean you have to be a really bad path to make a huge mistake like that right? I'm just nervous.

Thank you for your responses!

Last edited by hkwak002; 11-18-2011 at 08:18 AM.

Sponsors Lightbulb
Old 11-20-2011, 11:23 AM   #2
Join Date: Dec 2008
Location: California
Posts: 428
Chele60 HB UserChele60 HB UserChele60 HB UserChele60 HB UserChele60 HB UserChele60 HB User
Re: Is a punch biopsy good to take out a mildly atypical mole?

Hello and welcome!

Okay, this is just my own personal thing, but I don't know that I would be taking the word of a doctor over the internet who has never seen me or really doesn't know my condition. On this board, I tell people straight up I am not a medical professional, and what I know I know from my own experience and research. I also tell people if they are truly worried about something, they need to see (as in person) their own doctor - or find a doctor they feel comfortable with. Over the internet, we can all be who we want to be, we don't really have to give anyone any sort of credentials.

That said, you state you have mildly atypical moles. Are you even aware of what that means? And are you aware of how that relates to melanoma? Atypical moles may or may not eventually, possibly, at some time, in the future, way, way distant develop into melanoma. Could. Possibly. Maybe. And the stars could align just right and I, at the age of 51, could become Miss Universe. Detect a bit of sarcasm there?

There are 2 schools of thought as far as doctors are concerned. One school says, either leave the atypical mole alone, or do a shave/punch biopsy, and simply keep an eye on it and see if anything develops. The majority of the time? Nothing happens. The other school says, take full on preventative measure: do a complete wide excision in the event that melanoma may ever develop, and we will all be ahead of the game by taking out all of skin before it ever has a remote chance of ever taking hold.

What YOU need to think of - because, this is YOUR body that is being discussed - is there could be more atypical moles develop as you get older. A shave/punch removal is not all that bad in terms of having them removed. If you have an excision? Much more devastating to your body. You will have large chunks of skin removed. Now, granted, I'm sure a plastic surgeon would love to get a patient like that. Think about it, it isn't hard. A simple mole removal via punch really doesn't cost all that much. An excision? With perhaps local or general anesthia? With perhaps some level of reconstruction, depending on where the mole is located? Perhaps I'm cynical, but I'm seeing more dollar signs than patient care. Why would doctor necessarily care if s/he is carving up a patient (and scaring them to death) and receiving payments from insurance?

Hey, it's your body, it's your peace of mind. If you would feel better getting an excision for every atypical mole a doctor finds, you will certainly find a plastic surgeon willing to accommodate your wishes. Just allow yourself time to think and research about what you are doing, and have an open and honest conversation with your doctor.

Good luck!

Old 11-20-2011, 04:57 PM   #3
Join Date: Nov 2011
Location: California
Posts: 5
hkwak002 HB User
Re: Is a punch biopsy good to take out a mildly atypical mole?

Hi Chele60,

Thank you for your reply. So basically, I'm kind of blowing this thing out of proportion? I know what atypical moles are and how they are related to melanoma. From my research I know that having just one atypical mole increases my risk of melanoma in the future. I just have this fear that the pathologist (wasn't a dermapathologist) may not have done a good job looking at the mole and may have misdiagnosed it. I mean I'm sure under the microscope the difference between a mildly atypical mole and melanoma has to be big so to miss that has to be rare right? I'm just an overall paranoid person. My PA suggested a punch biopsy but I'm the one that pushed for an excision. I don't think it will be a full excision a bit smaller.

Also another thing is I just got a copy of my pathology report and the wording confuses me. My PA told me I just had two moles with mild atypia but on the report it says "lentiginous junctional nevus with mild atypical melanocytic hyperplasia extending to margins." I don't know if you would be able to decipher that but from my research I found that "atypical melanocytic hyperplasia" could possibly mean melanoma in-situ. I will ask my PA later but I'm just wondering if it is actually melanoma in-situ or just a mildly atypical mole. I don't think they would say its just atypical if in fact it is an in-situ. I mean since an in-situ is still melanoma there are cancerous cells and to say that its atypical just because its only on the surface would not be right.

Thank you for your input!

Last edited by hkwak002; 11-20-2011 at 05:02 PM.

Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Understanding biopsy results pofuduk Cancer: Skin 3 08-29-2011 08:19 AM
Extremely upset about biopsy-Doctor said she is worried-I am so upset mandamail88 Cancer: Skin 2 05-10-2011 12:45 AM
Waiting for mole biopsy cthy Cancer: Skin 1 09-29-2010 10:21 AM
How long for biopsy results? Lots of odd moles snbwcb Cancer: Skin 4 09-18-2008 12:36 PM
shave biopsy healing: Help, Belle2003? FearfuL Cancer: Skin 11 04-30-2005 01:08 PM
Punch Biopsy - Suspected Melanoma-Waiting bago Cancer: Skin 7 03-30-2005 06:03 AM
biopsy = cancer? FearfuL Cancer: Skin 8 02-16-2005 04:41 PM
mole with 3 different shades of brown?? waiting result of biopsy krp84 Cancer: Skin 4 01-26-2005 05:12 AM
11 yr old DD had biopsy of mole on top of her BIG toe. Referred to plastic surgeon. kippy6 Cancer: Skin 12 09-23-2004 06:44 AM
Biopsy Report Is Back Saraly Cancer: Skin 2 11-11-2003 09:57 AM

Thread Tools Search this Thread
Search this Thread:

Advanced Search

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off

Sign Up Today!

Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

I want my free account

All times are GMT -7. The time now is 02:06 PM.

Site owned and operated by™
© 1998-2018™ All rights reserved.
Do not copy or redistribute in any form!