Hi,

You are only the second person I've heard of that has been offered an incision biopsy. This seems to be a very recent decision and may not be undertaken by all hospitals. It sounds to me that it is primarily driven in an attempt to meet targets to diagnose and treat those with melanoma as currently hospitals are very behind with long patient lists.

The benefit though to patients is that, should the biopsy be negative, the scar is much reduced. 

For those with a positive biopsy - they will then have the remaining mole tissue removed during the Wide Local Excision procedure (done in all melanoma cases). However, it will cause worry that some cancer cells have been left behind between incision biopsy and the Wide Local Excision and raise a fear that it's had a chance to spread. I suppose that this fear is also inevitable during the long wait for an excision biopsy so there is no ideal solution whilst the Covid backlog exists.

I hope all goes well and the results bring good news. Please let us know how you get on.

Angie (Stage 3 melanoma patient since 2009)

I had a lesion removal due to suspected BCC and went private. They took it out first, then did histology. Was done quickly, and although I already had health insurance and was covered, the actual price for the surgery was something I would have paid anyway and was relatively cheap for just getting it cut out and done quickly. My scar on the back of the neck is about 2 inches long btw. These things are time critical, so I hope after they take a biopsy and you get the results, you don't need surgery and it is not a problem, but if you do need surgery, push hard to get it done quickly. 

Thank you [@AngieT]‍ and [@Glsalw]‍.  I had my incision biopsy yesterday.  Done by a lovely nurse.  It took much longer than I had expected (a good hour including confirming consent etc) but I'm pleased it's done and now I've got the dreaded wait for the results.  Thank you once again for your responses - I'm very grateful.

Good luck. Everything crossed for you.

Sadly, it was very bad news news for me.  Very disappointingly I will now have an excision biopsy to remove the whole skin change (it is a large mole) in a week and then once the results are known, I will have the Wide Local Excision.  Apparently a decision on the area for the Wide Local Excision is made on the basis on full biopsy results (which also takes some cells from around the mole) so I need to have the full removal of the mole first.  I will also be transferred to another hospital for the WLE.

I feel scared that it's spreading while all these steps are taken.  I also feel rather helpless in the face of all the uncertaintity.

I know it's a shock but hopefully it's been caught early. The WLE size is determined on the depth of the mole once it's been removed fully. The depth will also determine the Stage of the melanoma (along with any stray cells that may have broken away into the surrounding tissue, although this only happens in a small number of patients). 

Try not to panic - melanoma treatment is evolving all the time and is showing promising success.

Angie xx

Sad news as you say. Try to see this as now a step forward on the way to getting it sorted. It helped me thinking along the lines of 'it is what it is...now what we do about it ?'. The excision I had resulted in eight stitches and scar about 8cm long. About 7 weeks afterwards, the scar looks and feels amazing. Hardly notice it. The body heals amazingly. Just bought some Keli-Cote silicon scar gel to apply for next six months.