I was diagnosed with melanoma in situ on my upper left arm in May 2010. The original biopsy was done by the dermatologist and I went for a further excision of the area in June. The patho report of the 2nd excision stated that there were atypical melanocytes along the lateral margin. The plastic surgeon felt that with my skin type (fair and freckly) and background (Australian raised) it would be highly likely to find atypical melanocytes anywhere on my body and recommended to leave it and wait and watch. The pathologist recommended a further excision. I spoke with my primary and dermatologist and the derm spoke with the pathologist and I made the decision to go ahead with another, wider excision, in the search for the elusive clear margins. That was 2 weeks ago and I just got the report back and there are more atypical melanocytes. The plastic surgeon thinks I should leave it alone, but said he spoke with the pathologist, and it was suggested that another biopsy, perhaps a punch biopsy, could be taken on the same arm, but 2 or 3 inches away from the original site, to see if there were still atypical melanocytes. The thought is that if more atypical melanocytes are found, it could be fairly safely assumed that it is just my skin's long-term sun damage and not a reflection of any activity relating to the original melanoma. The plastic surgeon was careful to explain to me that atypical melanocytes are NOT melanoma cells, but I understand that the detramination is fairly subjective.
Does anyone have a recommendation for me or experience with similar?
Further, I asked the plastic surgeon to clarify for me that it was still considered "in situ" which he affirmed. I also asked him if a type of melanoma had been identified and he said that "in situ" is the type and that the other types (nodular, lentigo etc) only related to invasive melanoma. I wasn't aware of that.
I appreciate your responses and your help. I have been on here before with the same issues along the way, but feel I need some extra clarification with each step and I am really grateful for your support and advice.