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Previous melanoma 1A, now enlarged lymph nodes found 4 years in my armpit right by the previous melanoma site. What happens next if they're cancerous cells?

pinklady1979
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So I underwent a WLE 4.5 years ago for 1A melanoma on the back of my left upper arm. That came back with clear margins and I was discharged from Dermatology 3 years ago after regular 3 month checks. Three months ago I had another couple of mones removed which came back with clear histology, however I had raised calcium levels in my blood, and have had a couple of very low impact fractures this year (I’m age 46) so the dermatologist sent me for a full body and brain scan to be super cautious. A specialist nurse called with the results this week which have shown no metastases but have identified enlarged non-specific axillary lymph nodes in the armpit right by the previous melanoma site. The nurse said that I will have the scan repeated in 2.5 months to check them again. Then I had another call to say the Dermatologist wants a telephone appointment next week. 
I am aware that they could be enlarged due to an infection or virus, (I wasn’t unwell around the time of the scan) but also aware that as it’s only the nodes in my left armpit that are abnormal, it may well be that cancer cells could have drained into these from the previous melanoma. 

Had anyone else had experience of this? If it is cancerous cells what would the next steps be? 

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    Hi,

    I think that the dermatologist, to rule out it's melanoma related, may want to see you to examine the axillary node area (I assume you can't feel any lump)? If they can feel anything or the scan shows the nodes involved are easily accessible, they may arrange a fine needle biopsy. I've had one of these twice - once was for a small lump on my chest (came back clear) whilst an earlier one, on a lump in my groin, was positive for melanoma (I had previously been 1b - mole on my shin). I had to have a full node clearance from my groin & pelvis. That was 16 years ago - these days they either do a full node clearance & then a year of adjuvant drug therapy or they go straight onto the year of drugs & reassess a few months later as to whether a node clearance is also necessary (in many cases the drugs alone shrink & remove the melanoma in the node/s).

    Hopefully your nodes aren't cancer related & it's one less worry for you. Stage 1a has a 1-2% chance of spreading so the odds are on your side that it's not the melanoma that has returned. Good luck and please let us know how you get on,

    Angie (Stage 3 melanoma patient since 2009)

  • Offline in reply to AngieT

    Thanks Angie, Thats really useful info. I’m glad I have the appt as I want to ask him if there was a possibility that ulceration may have been missed in my previous melanoma. The first reason I noticed it was because it was ‘scabbed’. I thought I had caught my arm on something and rubbed moisturiser into it for a couple of months to see if it would clear up

    The scab eventually appeared improved so I didn’t get it looked at for a year, by which time the skin was just a little flaky. I never questioned the ‘no ulceration’ at the time of my initial report, as I had no idea what it meant but since the call last week I have read that the ulceration can regress and that if that’s the case, the staging would have been 1B or 2, and they would have removed lymph nodes to test then. I’m not catastrophising, but would like to ask the question and show my dermatologist the pictures I took, just in case…. 

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