I will try to make a long story short. Back in August I had an 8 mm mole removed from my calf that turned out to be melanoma. The original path report showed .89 breslow depth, Clarks level III, no ulceration, and it did not list a mitotic rate. My dermatologist did a WLE and said he does not recommend SLNB's for melanomas under 1mm breslow. The WLE came back all margins clear. In the meantime, I scheduled an appointment with an oncologist that specializes in melanoma at the Ohio State University for a second opinion. He had the original lab forward my slides to his pathologist. The original lab took over a month to forward the slides. I finally saw him today and his pathologist shows the mitotic rate is "approximately 1/mm2". He was struggling with whether or not to do a SLNB because he usually does it if the mitotic rate is higher than 1 and does not do it if it is lower than 1 and mine is "approximately 1". He tried to call the pathologist to get her opinion and could not reach her. He finally decided to have me see the surgical oncologist to let him decide. They should be calling me in the next few days with my appointment date and time for that.
I am a little shocked because I was hoping and assuming that I was just going today to get the final all clear and instead I am back into another waiting game and it appears I have gone from T1a to T1b based on that mitotic rate. I found an article on the Skin Cancer Foundation's website that says the AJCC Melanoma Staging System recommends a SLNB for patients with "T1 melanomas and secondary features associated with increased risk for nodal micrometastases: ulceration, mitotic rate greater than or equal to 1/mm2, or Clark's level IV, especially when the primary melanoma exceeds 0.7 mm in thickness". So mine is greater than 0.7 mm in thickness and has a mitotitic rate equal to 1/mm2, which means that I should have this test. Of course, this is just one opinion.
On one hand, I do not want another surgery, but on the other hand I would rather be safe than sorry. Does anyone else have any experience with this? If I do end up having the SLNB, what is the recovery time and how soon can I expect to go back to work? I have a desk job that does not require any manual labor or heavy lifting.