Will I be offered the SLNB along with the WLE?

Hi Mysticdaisy and a very warm welcome to the online community which I hope you'll find is both an informative and supportive place to be.

Hi Latchbrook, thank you for your response. I noticed you’re very helpful on this forum. 

My dermatologist said I might be offered the SLNB, however after reading these guidelines I’m not so sure, so I wanted to post here to make sure that I was reading them correctly or to see if anyone else has had a similar experience recently. 

I have my consultation next week so I’ll have more information then. I’ll make sure to update this post so it helps anyone else in a similar situation. 

Hi Mysticdaisy, I’m in a similar position to you. I was diagnosed with a stage 1B melanoma following removal of a mole from my chest. The mole was fully removed with normal tissue around the margins (2.5mm) and below (5mm). It had a maximum thickness of 1mm. The follow up treatment included a wide local excision (WLE) and sentinel lymph node biopsy (SLNB) as discussed with my support nurse and plastic surgeon. However, the multidisciplinary team decided that SLNB wasn’t necessary on the basis that there were no features of concern in the melanoma - no ulceration and zero mitoses. I had the WLE under a local anaesthetic around 3 weeks ago.

Last week, the nurse rang me with the results from the WLE. Fortunately, no cancer cells were found in the tissue sample. However, there were some precancerous cells on the surface of the sample associated with a nearby mole that was removed in the WLE - this was likely an in situ, stage 0 melanoma. Once again there were good normal tissue margins around this (2.5mm), although the nurse said they would prefer a 5mm margin. So, I may have to have a slight extension to my WLE.

I have an appointment later this month to discuss details and they may also do the surgery then.

Apologies for the long reply and best wishes to you.

Hi I too was diagnosed with 1b Melanoma but had mitosis rate of 6 however I was initially told I would have WLE and SLNB . However after referral to tertiary centre I Wasn't offered the SNLB .I was told this was due to breast cancer which I was diagnosed with 2 months previously. Do you have a date for consultation?

Hi Tony250, thank you very much for your response, it’s reassuring to hear from others who are/have been in a similar situation to myself! Mine was also removed with good margins, 1.5mm around it and 5mm below. Good luck with your follow up appointment at the end of the month. 
Do you ever worry about them not offering you the SLNB or are you completely reassured given the MDT said there were no concerning features? 

I have my consultation in a couple of days to discuss what’s next so I’ll make sure to update this thread with the outcome. 

Sorry to hear about your breast cancer diagnosis. I had a consultation with the plastic surgeon on 25th Jan and the WLE on 8th Feb. I have my next appointment on 26th March - possibly including the extended WLE. I found the cancer nurse to be very helpful in providing details.

Hi Mysticdaisy, I had similar margins to you on my mole removal with 2.5mm around the edge and 5mm below. I’m a bit frustrated about the other precancerous mole but at least it has been removed.

I do feel reassured about the decision of the MDT on the SLNB but I guess I do feel apprehensive about the possibility of spread, even though, statistically speaking, the chances are low. I’ll follow up by asking about monitoring and the next steps. Good luck with your consultation and I look forward to your update.

I found skin cancer nurse and nurses at our Macmillan centre great support.When I thought I'd found another Melanoma I was seen same day I sent photo and reassured 

That’s reassuring to know.

Hi Tony250, just wanted to update you, and anyone else reading this thread, after having my consultation today. The new guidelines are as above from the NICE website, they did offer me the lymph node biopsy purely on the basis that I’m young and they have the capacity to do so, other hospitals wouldn’t offer it and eventually they won’t either following the updated criteria. I’m also pregnant, so the SLNB is out of the question either way as they can’t delay the WLE and both would need to be done at the same time. I wouldn’t be able to go under general anaesthetic. So I’m in the same boat as you Tony250, it’s very reassuring to know someone else who doesn’t fall under the updated criteria for the SLNB. Hoping that our skin checks continue to be clear!