What is the purpose and goals of a sentinel lymph node biopsy for melanoma?

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VernonSondakMD (Physician - Surgery - Surgical Oncology (Verified) ) - 07 / 12 / 2012

Sentinel node biopsy is a “staging” test – it is first and foremost intended to determine whether the melanoma has spread to the lymph nodes, so that patients and doctors can decide what to do from there. As a lymph node staging test, it is excellent but not perfect: It finds most but not all patients with positive nodes, and does an excellent job overall in separating patients with a good prognosis (>80% chance of long-term survival) from those with a worse prognosis (~50% chance of long-term survival). By itself, however, a sentinel node biopsy does not increase survival – it just offers a prediction about who is most likely to survive. In most patients, we don’t think of the sentinel node biopsy itself as “treatment”. Obviously, compared to a treatment, a staging test or procedure should have a limited degree of short- and long-term side effects, and in the hands of an experienced surgery, sentinel node biopsy is definitely a safe procedure with few long-term side effects.
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