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The concept of the sentinel lymph node is important because of the advent of the sentinel lymph node biopsy technique, also known as a sentinel node procedure. This technique is used in the staging of certain types of cancer to see if they have spread to any lymph nodes, since lymph node metastasis is one of the most important prognostic signs .
Neither sentinel lymph node biopsy nor other diagnostic tests should be performed to evaluate early, thin melanoma, including melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm. [114] People with these conditions are unlikely to have the cancer spread to their lymph nodes or anywhere else and have a 5-year survival rate of 97%. [ 114 ]
A sentinel node biopsy can establish cancer staging of the axilla if there are positive lymph nodes present. [5] It is also less risky than performing a lymphadenectomy, having fewer side effects and a much lower chance of causing lymphedema. [5] If cancer is not present in the sentinel lymph nodes, then the axillary lymph node dissection ...
Treatment is by excisional biopsy, wide local excision and possibly sentinel node biopsy. Localized melanoma, which has not spread beyond the skin, has a very good prognosis with low recurrence rates. Spread of disease to local lymph nodes or distant sites (typically brain, bone, skin and lung) marks a decidedly poor prognosis.
It is advised to have a sentinel lymph node biopsy for lesions that are thicker or have high-risk characteristics. According to one study, patients who underwent an immediate lymph node dissection at presentation had a higher five-year survival rate than patients who underwent a delayed lymph node dissection.
A large study validated the importance of tumor depth (but not Breslow's original description) as one of the three most important prognostic factors in melanoma (the others being T stage and ulceration). [4] Breslow's depth also accurately predicted the risk for lymph node metastasis, with deeper tumors being more likely to involve the nodes. [5]
The general location of the sentinel node is determined with the use of a handheld scanner with a gamma-sensor probe that detects the technetium-99m–labeled tracer that was previously injected around the biopsy site. An injection of Methylene blue or isosulfan blue is done at the same time to dye any draining nodes visibly blue. An incision ...
The TNM Classification of Malignant Tumors (TNM) is a globally recognised standard for classifying the anatomical extent of the spread of malignant tumours (cancer). It has gained wide international acceptance for many solid tumor cancers, but is not applicable to leukaemia or tumors of the central nervous system.
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