When Is Sentinel Lymph Node Biopsy Recommended for Melanoma?

A surgeon identifies the first lymph node, or small group of nodes, likely to receive drainage from the melanoma site. The node is removed and examined for melanoma cells. A negative result can provide useful staging information; a positive result means melanoma cells were detected in that regional node and may change the discussion about further treatment.

The decision depends on the pathology report, including tumour thickness, ulceration and other microscopic features, as well as the melanoma’s location and your overall health. It is a staging procedure, not a treatment that removes every melanoma cell.

Discuss the biopsy soon after the melanoma diagnosis and before or during planning for wide local excision. Ask whether the pathology features make the procedure useful, what recovery involves, and how the result would affect follow-up or treatment choices. Tell the team about medicines, allergies, previous lymph-node surgery and conditions that may affect anaesthesia or wound healing.

Contact your melanoma team promptly for a new or enlarging lump near the scar, persistent swelling of an arm or leg, unexplained bleeding, or a wound that becomes increasingly red, warm, painful or draining. Seek urgent medical help for breathing difficulty, sudden severe swelling or heavy bleeding after the procedure.

Which features in my pathology report support or argue against sentinel lymph node biopsy? Where would the node be located, and how will it be found? What result would change my next appointment or treatment plan?