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So, being a veteran of numerous unpleasant encounters with Dermatologists over the years, I am left with many questions as to the accuracy and precision standards in diagnostic/treatment process.
Very rarely do I get answers to these questions from busy Dermatologists.
Someday, I may get answers .. in the meanwhile I am resigned to having to live in hope ...
My first question is how accurate is pathology diagnosis? I have had fairly extensive subsequential excision surgery (skin), following a biopsy, only to find out that the original lesion was entirely removed by the original biopsy. I felt like the second stage treatment was entirely unwarranted. Upon going back and reading the original biopsy report myself, I found rather ill-defined terms like "leading towards", which seemed sufficient justification (for the referring Dermatologist) to pass me onto a plastic surgeon for further removal of a sizable chunk of me.
Until this encounter, I was entirely unaware that there is still significant uncertainty following the pathology/biopsy stage.
The second question is about the 'surgical margins' taken during the excision process. It would seem that the size of the chunk removed by these folk is entirely arbitrary, (at the upper end of the scale), and it is this, that can result in the removal of major chunks of body parts … perhaps unnecessarily so (?)
My concern is that frequently, we place our care into the hands of busy professionals who are motivated to make decisions on our behalf, which may involve exceeding the 'minimum' amount needed to remedy the cause of the problem, especially given the uncertainty in the pathology domain.
I am aware of the 'better-to-be-safe-than-sorry' counter to all of this, but following several encounters, I am left with feelings that there are more options, than we are frequently led to believe behind a closed door.
Cheers
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