Don't understand husband's Dermatopathology Report

My husband received a specimen report yesterday from an excision from the skin above his right cheek. It says Basal Cell Carcinoma, nodular type. Margins negative. Actinic Keratosis. No mention of what stage. We wanted a referral to a dermatologist but were refused. Shouldn't he be seen by a dermatologist? He works outside and has a lot of moles.
Thank you.

Hi,
I am glad you found EmpowHER, and we can help you decipher part of your husband's lab report. I say "part", because you and your husband need be feel 100% clear about his diagnosis, treatment and prevention plan regarding his skin cancer. If you do not understand the report, please call his doctor's office and speak with the doctor or a nurse who can talk with you step-by-step about the report, as well as what you can expect for future. Does your husband know how to prevent further skin damage, does he know the signs of skin cancer (he has a higher chance of developing skin cancer in the future). These are questions that need answers from your husband's doctor. The National Cancer Institute (NCI) is a great source of credible information as well, EmpowHER has an entire site dedicated to melanoma (click on underlined word), and I have included a list of the NCI's recommended questions for a doctor below.

Your husband's medical report included many medical terms, and I have listed the definitions below, followed by a "translation". Again... it is vital that you call and confirm this information with his doctor. There is no substitute suitable enough than your husband's own doctor to translate his personal patient lab report, as each one is slightly different and it is crucial to completely understand the report and what is expected of him for future check up's and prevention of further disease.

REPORT READS:
1) "Melanocytic"= presence of melanocytes (type of cell with pigmentation), mostly found in skin.

For your purposes:
"melanocytic" = "pigmented skin cells"
"Atypia" or "Atypical"= lacking uniformity (normal cells are uniform)

NEW WAY TO READ:
1) Pigmented skin cells are lacking uniformity in a moderate-to-severe degree

REPORT READS:
2) "Partial regression"= shift toward less severe disease
"Superficial"= affecting only surface; not penetrating other areas
"Malignant" = tumor/cancer/invasive
"Melanoma"= type of skin cancer
"Compound"= combined
"Neoplasm"= a new and abnormal growth of tissue in some part of the body, esp. as a characteristic of cancer.
"Cytologic"= disease of atypical cells is moderate to severe

2) NEW WAY TO READ:
Melanoma (skin cancer) found is only superficial (on surface), and has been found as less severe from a previous state. A new abnormal cell growth (skin cancer) is moderate-to-severe.

LAST PORTION OF REPORT:
Treatment advice is to "re-excise" ("exise" = surgically remove) skin cancer with one cm margin ("margin" = "extra" amount of skin surrounding tumor that is normal skin, to ensure cancer is removed).

According to the NCI, "Most skin cancers can be cured if found and treated early. Sometimes all of the skin cancer is removed during the biopsy. In such cases, no more treatment is needed."

What you need to know from your doctor/nurse is:
1. Has this "re-excision" stated in the report as treatment advice already been done? Was a one centimeter margin done? If so, when are the results of this test (they will test the margin of the normal skin to ensure all the cancer was removed)
2. Has all of the skin cancer been removed during the biopsy?
3. What precautions need to be taken for future prevention?
4. What is the likelihood of my husband having skin cancer again in the future?
5. When are his check-ups, and how often does he need to be seen?

You may also want to know what "stage" cancer his melanoma was found to be in. It sounds like it was a "stage 0", as this can help you in your research as well.

Stages of melanoma:
Stage 0: the melanoma involves only the top layer of skin, called melanoma in situ.

Questions to call and ask the doctor (from NCI):
You may want to ask your doctor these questions before you begin treatment:
• What is the stage of the disease? Has the cancer spread? Do any lymph nodes or other organs show signs of cancer?

• What are my treatment choices? Which do you suggest for me? Why?

• What are the expected benefits of each kind of treatment?

• What can I do to prepare for treatment?

• Will I need to stay in the hospital? If so, for how long?

• What are the risks and possible side effects of each treatment? How can side effects be managed?

• Will there be a scar? Will I need a skin graft or plastic surgery?

• What is the treatment likely to cost? Will my insurance cover it?

• How will treatment affect my normal activities?

• Would a research study (clinical trial) be a good choice for me?

• How often should I have checkups?

Source: National Cancer Institute: http://www.cancer.gov/cancertopics/wyntk/skin/page10
Source: Medical Dictionary at NLM http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

Does this help? Do you have any additional questions?