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Standard depth of a Squamous Cell Carcinoma excision

GaryTG
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About a month ago I had what was thought to be an SCC on my scalp. However it turned out to be a Melanoma. I understand the surgeon wouldn't have known this when she operated. From the biopsy, the Breslow depth was 2.6mm.

My questions are how deep would a surgeon typically go for a) an SCC and b) a melanoma. I ask in case they would both automatically be deeper than 2.6mm. [I understand there would still be a chance of it spreading even if they went deep enough]

The biopsy identified the depth (ie 2.6mm) but I can't seem to get any information on whether there was any margin BELOW what turned out to be a melanoma.

Thanks

  • Hello GaryTG and thank you for posting,

    I am sorry to learn of your situation this must be a difficult time,

    I might be wrong, but it sounds like you may have just had the biopsy, and so this means they have just removed the melanoma, this is known as a local excision.

    Now a definite melanoma has been diagnosed, you will likely need to have another operation, called a wide local excision, this is when healthy tissue is removed from around where the melanoma was.

    How much tissue is removed will depend on several things; whether any melanoma cells were left behind in the surrounding skin, how deep the melanoma had grown into the tissue beneath the skin, and where the melanoma is in the body.

    The best person to discuss this with will be your consultant at the hospital as they know your case and will be able to clarify for you what your situation is.

    Please feel free to get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care, all the best

    Jemma

  • Offline in reply to CRUK Nurse Jemma

    Thank you for your reply. It will be another 2 weeks before my appointment with the consultant. The excision was substantially wider than the SCC/Melanoma since it was sitting on top of a (benign) lentigo. They have already confirmed that there was sufficient horizontal margin (even around the lentigo). I was trying to establish whether the surgeon would have automatically gone deep enough when they assumed an SCC...or am I at risk of needing a further excision into the new skin graft to get deep enough to make sure they have got all of the melanoma. If they know the Breslow depth (2.6mm) surely they would know if there was any margin BELOW that depth.....but no-one seems able to tell me...which is why I asked the straightforward question of what depth is normal for an SCC excision. I'd rather know now rather than worrying for the next 2 weeks. They have already down the biopsy but no-one seems to know about the depth margin. I have asked but have no answer. I'd just like to know rather than have (perhaps) unnecessary worry.

  • in reply to GaryTG

    Hello and thanks for getting back to us again.

    I have enclosed some information by the British Association of Plastic Reconstruction and Aesthetic Surgeons (BAPRAS) which has guidelines on excision margins for Malignant Melanoma | BAPRAS

    I am sure that they would have wanted to have an equally clear margin around your suspected Squamous cell carcinoma but I really feel that this is best answered by your specialist.

    I don't think the margins are straightforward. I think the size of the margin is dependent on the size of the cancer and also where it is in the body and whether there are any other structures nearby. I am also not a surgeon and they are really the best people to answer your questions based on your individual case.

    You are of course more then welcome to ring and chat this through with one of the nurses on the helpline.

    Our number is Freephone 0808 800 4040 and the lines are open Monday to Friday 9 am to 5 pm.

    All the best,

    Catherine

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