Stage 1B

I was diagnosed with stage in t1a scalp melanoma in January. My dermatologist had concerns considering the thickness of the tumor was .8mm which was near borderline for t1b and recommended a Castle Bioscience test on the biopsy. The results came back with a likelihood of an SLNB positivity rate of 4.2% which is less than 5%. Everything below 5% would not generally recommend an SLNB. They had difficulty tracing blood flow from the tumor area to any specific lymph nodes and used this test in their decision process during the WLE to forgo the SLNB.

I will be monitored using ultrasound imagery of my lymph nodes for the next several months to be sure I don't present any type of swelling.

I was diagnosed with stage 1b at the beginning of March and have just been given the all clear. I had two ultrasound scans done of my groin lymph nodes. The first showed a couple of slight Inflamed nodes, which they thought was possibly due to the initial operation, so had  second one a few weeks later just to make sure and it  came back clearl. Apparently they can tell the difference between normal lymp nodes and cancerous ones as cancerous ones have their own blood supply.

I was given the option to have a SLNB, but declined as I decided that the possible side effects outweighed the reason for having it. I was also told by my nurse that it only showed what was in that particular lymph node at that moment in time, and told me I had made the right decision.

It's easy to think the worse, and hard to think the best, but tell yourself you are OK, that you are now cancer free and most of all start to live your life again. 

Hi

I was diagnosed 1b in June 2022 and had WLE in August. I wanted a SLNB but it wasn't offered as tertiary centre who advise said I wouldn't be a candidate for immunotherapy as had also been diagnosed with breast cancer the previous month. This obviously makes me anxious but I have had an ultrasound of axilla and will have another so I'm crossing everything. I know how you feel and having to wait 10 weeks for result is crazy ,I thought 2/3 weeks was tough. 

Hi CMO, is the Castle Bioscience test offered in the UK? I always thought this was something only available in the US. 

Hi Mysticdaisy,

I am in the US and not sure if available in the UK. It's been 18 months since surgery and all lymph node monitoring using ultrasound has come back negative.

I think it’s a US thing, although I do wish it was offered over here as I would definitely look into it. That’s brilliant, how deep was your original melanoma? Mine was 1.0mm with no other concerning features. 

It was .8mm which is at the maximum limit for t1a prognosis. My Dermatologist was concerned with the depth of the biopsy and thought it should have been clinically diagnosed as t1b and recommended the Castle Bioscience test along with a higher level of monitoring.