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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 .
Melanoma metastasizes early into regional lymph nodes, so excision and analysis of so-called sentinel lymph nodes is important for treatment planning and prognosis assessment. To identify the sentinel lymph node for excision, a gamma-emitting radiotracer is injected inside the primary tumor and allowed to accumulate inside the sentinel lymph node.
See Lymphadenectomy#With sentinel node biopsy. However, Sentinel lymph node biopsy for evaluating early, thin melanoma has not been shown to improve survival, and for this reason, should not be performed. [1] Patients with melanoma in situ, T1a melanoma or T1b melanoma ≤ 0.5mm have a low risk of cancer spreading to lymph nodes and high 5-year ...
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.
The prognosis of acral lentiginous melanoma is based on multiple factors including gender, age, race, Breslow depth, staging, and sentinel lymph node positivity. [7] Out of these factors, it is believed that sentinel lymph node positivity provides the strongest prediction of cancer recurrence and death.
Donald Lee Morton (September 12, 1934 – January 10, 2014) was an American surgical oncologist who was best known for developing sentinel lymph node evaluation, a procedure that, by some estimates, saves the U.S. healthcare system nearly $4 billion annually in the treatment of melanoma and breast cancer. [1]
For example, it has been found that the prognosis of women who have micrometastases to the sentinel lymph node is poorer than that of women who do not have any evidence of tumor in these lymph nodes. [2] The same applies to patients with melanoma and the other solid tumor cancers. [citation needed]
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 ...