Hi there David,

The world of melanoma is a confusing place to be I'm afraid. To try to simplify it - moles can either be benign, atypical (also known as dysplastic or precancerous) or melanoma which comes in 4 stages - Stage 0 known as in-situ which means it hasn't broken through the skin into the epidermis, Stage 1 which is where the depth is generally less than 0.8mm to 1mm thick, Stage 2 is more than 1mm thick, Stage 3 is where it's spread to the lymph nodes & Stage 4 is spread to organs etc.

In your case (it happens sometimes) the histologist isn't 100% sure of the thickness of your very shallow mole & it sounds like the cells are on the verge of being cancerous (so atypical) or are cancerous. In these cases they send the tissue sample to another hospital that has more experience & can give a second opinion. 

They want to ensure the right diagnosis because an atypical mole wouldn't need further excision, whilst an insitu (Stage 0 melanoma) would require further removal of the surrounding tissue to ensure that a cancer cell hasn't broken away & lodged close by. If they 'assume' it's insitu when it isn't, they 'overtreat' the patient by doing further surgery that isn't necessary and is larger & takes longer recovery time than the initial excision. Some hospitals prefer to be cautious & get it right like yours is doing, whilst others 'assume' it's melanoma to be 'on the safe side.'

I know it's putting more worry on your shoulders but they want to get it right first time & not miss anything or put you under the knife again unnecessarily.

I hope this helps & I hope the result comes back atypical. If it's insitu, it's been caught as quickly as possible so it can be successively treated with the further excision. Good luck and please let us know how you get on,

Angie (Stage 3 melanoma patient since 2009)