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ShareSENTINEL LYMPH NODE BIOPSY and
WLE WIDE LOCAL EXCISION
Sentinel Lymph Node Biopsy
Sentinel node biopsy is a staging procedure. This has become a common way to find out if the cancer has spread to nearby lymph nodes. It can find the lymph nodes that drain lymph fluid from the area of the skin where the melanoma started. A surgeon injects a radioactive liquid and a blue dye into the area of the melanoma. The lymph nodes are then checked for radioactivity to find which ones are the first to drain fluid from the skin near the melanoma. These are the sentinel lymph nodes, called that because they "stand watch," so to speak, over the tumor. A small incision is made in the identified lymph node area. The lymph nodes are then checked to find which one(s) turned blue.
When these lymph nodes have been found, they are taken out and looked at under a microscope. If cancer cells are found, it is generally recommended that the rest of the lymph nodes in this area are removed (depending on results of additional testing/scans for possible further spread of melanoma). If no cancer cells are found in the sentinel lymph node, then the chance of cancer having spread to other parts of the body is low. However, the advantages for sentinel lymph node biopsy in melanoma are still being studied and debated.
Sentinel node status in melanoma is the best staging and prognostic indicator: patients with negative results have a better prognosis then those with positive results. However, there is no evidence yet from clinical trials that complete lymph node dissection in patients with positive sentinel node biopsies offers any survival advantage. This is one of many diagnostic and treatment decisions you will need to make. Do further research, discuss it with others and get medical opinions so you can make the best choice for you.
WLE Wide Local Excision
A wide local excision (WLE) is the surgical removal of the primary melanoma along with a rim of normal skin surrounding the tumor. Sometimes a skin graft is necessary to fill in the space. A 1 cm clearance is adequate for lesions less than 1 mm thick and a 2 cm margin for lesions up to 4 mm thick. There is little data to support the use of margins wider than 2 cms even in lesions greater than 4 mm thick. Again, be sure to obtain a copy of your pathology report during your follow-up visit.
Information on this page has been cited from the Melanoma Research Foundation (www.melanoma.org) - 2011
