Help me understand nodular melanoma

Hi, 

I'm 5months postpartum and completely freaking out. In the last 3 months of my pregnancy I had a mole underneath my belly button get bigger and very dark. I put it down to pregnancy changes, but just been told by a dermatologist yesterday that this mole has starburst borders and needs to be taken out for biopsy. I'm waiting for this biopsy to be booked through the NHS, yesterday I saw a private dermatologist.

I'm panicking because this mole doesn't look bad, so it's not those type of melanomas that spreads horizontally. It's all the same dark black color, on the naked eye it looks symmetrical and with even borders (we know from the dermoscopy yesterday that the borders are not even after all but in a starburst pattern). Since it doesn't have the characteristics of the melanoma that spreads horizontally does that mean it's nodular melanoma? It doesn't have a bump per se but the whole area of the mole is ever so slightly raised. But it's not dome shaped and it almost seems flat.

I know nodular melanomas spread very fast and I'm very scared I left it too late. I can't think properly and I need to take care of my 5 month old baby. My previous partner died of cancer so it's all just flooding back. Any clarification on nodular melanoma would be greatly appreciated. Thank you!

  • With your condition and if you can afford it suggest you go the private route, if only initially to get the consultation and tests done. I was "fast track" referred for a black growth on my head (suspected squamous cancer) in early July, the biopsy done mid August and am still awaiting the results 6 weeks later. Had I known the fast track is not fast I would have paid, hope it all goes well for you either way.

  • Hi,

    I'm sorry you have this worry, especially after just having had a baby (Congratulations). 

    Firstly, moles often change during pregnancy due to hormone changes but it doesn't always mean they are melanoma so don't worry that, if it's changed, it must be cancer (my niece has had mole changes & they were removed during her 2 pregnancies - they were benign). 

    Moles with a starburst border can be malignant or benign so again, it doesn't mean it's definitely melanoma.

    With regard to nodular v superficial spreading melanoma - these melanomas don't always follow a definite image as seen online. Nodular melanoma is typically raised with irregular patches of colour and irregular border - it usually grows downwards rather than on the skin & sometimes it can have no pigmentation. Superficial spreading melanoma however, doesn't always spread on the skin but grows downwards - it can also be slightly raised but not usually as raised or dome shaped as a nodular melanoma. Mine, on my shin, was a childhood mole that got very dark (almost black) but didn't get any larger on the skin. So if your mole is melanoma it sounds from your description that it's probably superficial spreading rather than nodular. Of course, no one (not even the consultant) can tell what it is - only a biopsy can do that so it's good yours is being removed.

    Try not to panic - there is a good chance the mole is fine but, if it is melanoma, it's being dealt with and treatment is great these days so hopefully it will be treated quickly & successfully. Good luck and please let us know how you get on,

    Angie (Stage 3 melanoma patient since 2009)

  • Hi Angie,

    Thank you so much for such a detailed reply. I've seen so many of your replies here in the chats over the years. I think a lot of people are thankful to you!!

    Yes, totally understand that no one can give a definitive answer without a biopsy. I guess I'm only scared because it hasn't grown that much superficially and I'm wondering if that means I'm lucky and caught early or unlucky and it's been growing downwards instead. I'm waiting for the hospital's dermatology department to book my removal, apparently there's quite the backlog because so many people are aware of skin cancer now. I'm thinking about maybe doing it privately if it takes too long. I kinda just want it out at this stage. Hopefully it won't be anything, like with your niece. It's just scary cause it really is very very dark. 

    I'll try and remember to keep you all posted on how it goes.

    Joana