Should I Remove a 1cm Mole on My Shoulder Before Chemotherapy?

There is a mole with a diameter of 1 centimeter on my right shoulder, and I am unsure whether it should be removed?

Hello, doctor.
I have had a mole about 1 centimeter in diameter on my right shoulder since childhood.
I may need to undergo chemotherapy soon, and I'm concerned about the possibility of it becoming cancerous in the future.
Recently, I consulted both a dermatologist and a plastic surgeon.
The dermatologist suggested that I could have it excised, but the plastic surgeon expressed concerns that excision might lead to the formation of a keloid, so he does not recommend removal and advised me to reconsider.
After hearing this, I became very hesitant...
So I would like to ask whether I should have this mole, which is about 1 centimeter in diameter, removed.

You Yu Wen, 20~29 year old female. Ask Date: 2014/05/19

Dr. Wu Yuxin reply Dermatology

Chemotherapy? There is no direct relationship between chemotherapy and the changes in moles; they should be discussed separately.
If there are concerns about a mole changing, it should be excised.
Whether keloids will form depends on the individual's medical history or constitution.
If there is a history of keloid formation from previous wounds, then it should be considered; otherwise, it cannot be predicted.

Reply Date: 2014/05/19

More Info

When considering whether to remove a 1cm mole on your shoulder before undergoing chemotherapy, it's essential to weigh the potential risks and benefits carefully. The decision should be made in consultation with your healthcare team, including your oncologist and dermatologists, as they can provide tailored advice based on your specific medical history and the characteristics of the mole.

Understanding the Risks
1. Potential for Malignancy: One of your primary concerns seems to be the possibility of the mole undergoing malignant transformation, especially with the impending chemotherapy. Chemotherapy can suppress the immune system, which may affect the body's ability to fight off any potential malignancies. If there is any suspicion that the mole could be atypical or changing, removal may be warranted to prevent any future complications.

2. Surgical Risks: The dermatology specialist has suggested that removing the mole could lead to complications such as keloid formation (also known as crab foot scar). Keloids are raised scars that can occur after skin injury and may be more common in certain individuals, especially those with darker skin tones or a family history of keloids. If you have a history of keloids or if your skin is prone to scarring, this is a significant consideration.

3. Healing Time: Surgery involves a healing period, and if you undergo mole removal, you will need to allow time for recovery before starting chemotherapy. This could delay your treatment schedule, which may be a critical factor depending on your cancer diagnosis.

Benefits of Removal
1. Peace of Mind: If the mole is removed and sent for histopathological examination, it can provide peace of mind knowing that it has been evaluated for any signs of malignancy. This can be particularly reassuring before starting chemotherapy.

2. Monitoring: If the mole is left in place, it will require regular monitoring for any changes in size, shape, or color. If you are already anxious about your health and the upcoming chemotherapy, the presence of a potentially concerning mole may add to your stress.

Recommendations
1. Consult Your Oncologist: Discuss your concerns with your oncologist, who can provide insights into how the mole's removal might impact your overall treatment plan. They may also have specific recommendations based on your cancer type and stage.

2. Consider a Third Opinion: If you are still unsure after consulting both dermatology and plastic surgery, consider seeking a third opinion from another dermatologist or a surgical oncologist who specializes in skin lesions. They may provide a different perspective on the necessity and timing of the mole's removal.

3. Evaluate the Mole: If the mole has not changed over the years and is asymptomatic (not causing pain, itching, or bleeding), it may be reasonable to monitor it closely rather than remove it immediately. However, if there are any changes or if it has an irregular appearance, removal may be the best course of action.

4. Discuss Timing: If you decide to proceed with removal, discuss the timing with your healthcare team to ensure that it fits well within your chemotherapy schedule.

In conclusion, the decision to remove the mole should be made collaboratively with your healthcare providers, considering both the potential risks of leaving it in place and the complications that may arise from surgical removal. Ultimately, your health and peace of mind are paramount, and a well-informed decision will help you feel more confident as you move forward with your treatment.

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