Sentinel Node Biopsy is Indicated for Thin Melanomas ≥0.76 mm

The Challenge of Defining Guidelines for Sentinel Lymph Node Biopsy in Patients with Thin Primary Cutaneous Melanomas

“…2) In patients whose primary tumor is between 0.76-1.00 mm, the probability of a positive SLN increases into the 6-11 % range; within this cohort, patients with T1b melanomas (ulcerated or with a mitotic rate C1/mm 2 ) are even more likely to have a positive SLN. 8,[13][14][15] 3) There is strong evidence that ''younger'' patients are more likely to have a positive SLN, although available data do not adequately define what age serves as a clinically appropriate cutoff. 4) There is little convincing evidence that patients with thin melanomas who have Clark level IV invasion are more likely to have a positive SLN.…”

The Role of Sentinel Lymph Node Biopsy in Thin Melanoma (Breslow Thickness ≤ 0.75 mm and 0.76 mm - 1.0 mm Respectively): Our Results and Review of the Literature

“…The guidelines in regard to Breslow thickness, taking in mind where SLNB staging benefits do not outweigh the risks of the procedure, are constantly reviewed and modified. Factors associated with increased incidence of positive SLNs in melanoma patients have been thoroughly studied and reported in the literature and include tumor thickness [5]- [24], ulceration [16]- [22], mitotic rate [7] [14] reported positive SLN in the ≤0.75 mm group (group A), ranging from 1.7% to 6% (Table 4). In our study (Table 1) in the 0.76 -1.00 mm group (group B) the percentage of positive SLNs was 11.1%, whereas in the above-mentioned studies [5]- [14] it was ranging from 3.9% to 12.8%.…”

“…Factors associated with increased incidence of positive SLNs in melanoma patients have been thoroughly studied and reported in the literature and include tumor thickness [5]- [24], ulceration [16]- [22], mitotic rate [7] [14] reported positive SLN in the ≤0.75 mm group (group A), ranging from 1.7% to 6% (Table 4). In our study (Table 1) in the 0.76 -1.00 mm group (group B) the percentage of positive SLNs was 11.1%, whereas in the above-mentioned studies [5]- [14] it was ranging from 3.9% to 12.8%. Because of the existence of the above studies with positive SLNs in the Breslow thickness ≤ 0.75 mm group (group A), the SLNB procedure in melanoma patients with Breslow thickness ≤ 0.75 mm should be considered on an individual basis when "high-risk features" are present.…”

A Review of Frequent Cutaneous Malignancies – Part Ii: Malignant Melanoma

“…Regarding melanomas with a Breslow grade of 0.76 to 1 mm, sentinel lymph node is recommended when one of the risk factors is present: ulceration, Clark level equal or greater than IV, male sex, mitotic rate higher than 1 and head and neck location (21).…”