Stage III (invasive melanoma) is about the level of lymph node(s) that have melanoma, if it has spread to one or more the nearest lymph nodes. This stage is very complex and super detailed, so I’ll be sharing this in two parts! So let’s starts with PART 1: If the melanoma developed in the skin or dermis along the lymphatics prior to reaching a lymph node, this is called in transit or satellite metastasis. (No evidence it has spread) In stage III, there are 4 subgroups: IIIA, IIIB, IIIC, IIID.
I was Stage IIIC, anyT N3 >4 metastatic. I found out, melanoma was in my nodes in 2008, just 2 weeks after the birth of my second daughter. I did have my armpit redone 2x’s after the org operation. (It done wrong & for trial)
*Microscopically, also called clinically occult = seen by pathologist during biopsy or dissection
* Macroscopically, also called clinically detected = seen by naked eye or felt by hand or seen on CT scans or ultrasound
The subgroups are defined by the TNM
T= TUMOR (primary)
T0 means no evidence of a primary tumor. T1 less than 1mm thick
T1A- are less than .8mm thick and are NOT ulcerated.
T1B- are less than .8mm thick and ARE ulcerated; or are .8-1mm thick and can be ulcerated or not.
T2- includes tumors that are greater than 1mm can be, up to 2mm thick.
T2A- greater than 1mm and up to 2mm thick and DO NOT have ulceration.
T2B- greater than 1mm and up to 2mm thick and ulcerated.
T3- tumors that are 2.0 to 4.0 mm thick.
T3A- tumors 2-4mm thick and are NOT ulcerated.
T3B- tumors are 2-4mm thick and ARE ulcerated.
T4- includes tumors that are greater than 4mm thick.
T4A- tumors are greater than 4mm thick and are NOT ulcerated.
T4B- tumors are greater than 4mm thick and ARE ulcerated.
N=NODE
Based on the original spread of your melanoma, beyond the primary tumor.
N1- spread to only 1 lymph node; OR there is in-transit, satellite, or micro satellite metastasis.
N1A- there’s 1 positive lymph node was clinically occult.
N1B- there’s 1 positive lymph node, clinically detected.
N1C- no lymph nodes, positive with melanoma but there IS in-transit, satellite, or microsatellite metastasis.
N2- spread to 2 or 3 lymph nodes; OR that there is in-transit, satellite, or microsatellite metastases AND 1 positive lymph node.
N2A- 2-3 positive lymph nodes were clinically occult.
N2B- 2-3 lymph nodes were clinically detected.
N2C- 1 lymph node was positive, either clinically occult or clinically detected AND there is in-transit, satellite, or microsatellite metastasis.
N3- spread to 4 or more lymph nodes OR there is in-transit, satellite, and/or microsatellite metastases with 2 or more positive lymph nodes OR any number of connected nodes WITHOUT or with in-transit, satellite, and/or microsatellite metastasis.
N3A- 4 or more positive lymph nodes were clinically occult.
N3B- 4 or more positive lymph nodes were clinically detected.
N3C- 2 or more lymph nodes were positive, either clinically occult or detected AND/OR there are any number of matted nodes AND there is in-transit, satellite, and/or microsatellite metastasis.
M=METASTASIS (distant metastasis).
Stage III melanoma doesn’t have distant metastasis, you just end up being
M0=no evidence of distant metastasis. Dr and patients will then examine your most recent pathology report and find your TNM score. They then use a chart to find your score.
**My TNM score was: STAGE III TN3, M0 greater than 4, but it spread just as quick! I was stage IV just months later. This stage, gave me 27% chance to live past 5 yrs of diagnosis and 18% chance to live past 10yrs of diagnosis!! WTH those numbers scare me, still.**
*please seek medical support if you have areas of concern*