Related Experiment Video
Updated: Jul 25, 2026
07:51
The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Sentinel lymph node biopsy for melanoma: experience with 234 consecutive procedures
J D Wagner1, L Corbett, H M Park
1Department of Surgery, Indiana University School of Medicine at Indiana University Purdue University at Indianapolis, USA. jdwagner@iupui.edu
Plastic and Reconstructive Surgery
|June 6, 2000
Summary
Sentinel lymph node biopsy (SLNB) is reliable for melanoma staging in experienced hands. It is most beneficial for patients with thicker melanomas (>1.2 mm), ulceration, or high mitotic index, identifying occult metastases.
Area of Science:
- Oncology
- Surgical Pathology
- Dermatology
Background:
- Sentinel lymph node biopsy (SLNB) is a key staging procedure for cutaneous melanoma, aiming to detect occult metastases.
- Patient selection for SLNB and subsequent lymphadenectomy remains a subject of clinical debate.
- Accurate identification of patients benefiting from SLNB is crucial for optimizing treatment strategies.
Purpose of the Study:
- To analyze a large clinical series of SLNB procedures for cutaneous melanoma.
- To identify specific patient and tumor characteristics predictive of positive SLNB results.
- To evaluate the utility of SLNB in guiding further management decisions.
Main Methods:
- Retrospective analysis of a database of patients with clinically localized cutaneous melanoma who underwent SLNB.
- SLNB performed using preoperative technetium Tc 99m lymphoscintigraphy and isosulfan blue dye.
- Statistical analyses including univariate and multivariate logistic regression and classification tables to identify predictors of nodal positivity.
Main Results:
- Of 234 SLNB procedures, 20.1% were positive for melanoma metastasis.
- Melanoma thickness (Breslow's), ulceration, and mitotic index were significant predictors of positive SLNB.
- A Breslow thickness cutpoint of 1.2 mm demonstrated high efficiency in predicting SLNB positivity.
- Completion lymphadenectomy in positive SLNB cases revealed additional positive nonsentinel nodes in 26.1% of patients.
Conclusions:
- Sentinel lymph node biopsy is a highly reliable staging tool for melanoma when performed by experienced teams.
- SLNB is particularly valuable for identifying occult metastases in patients with melanomas >1.2 mm, or those with ulceration or high mitotic index.
- Completion lymphadenectomy is recommended following a positive SLNB due to the difficulty in predicting nonsentinel node involvement.
