Don’t perform lymphoscintigraphy and radioguided biopsy of the sentinel node in patients affected by cutaneous melanoma thinner than 0.75 mm, with no ulceration and mitotic rate <1/mm2

Type of practice


Topic Area

Nuclear Medicine

The treatment of choice for these patients is adequate surgical removal alone of the primitive tumour. Given the optimal prognosis (97% survival at 10 years), radioguided biopsy of the sentinel node would imply useless exposure to ionizing radiations, as well as surgical “overtreatment” of selective removal of the sentinel node. The NCCN guidelines (version 4.2014) indicate that the search for the sentinel node, at any anatomical site, can be considered on an individual basis in patients with melanomas of thickness between 0.75 and <1 mm with at least 1 mitosis/mm2 or with ulceration, and for all melanomas of thickness between 1 and 4 mm. Biopsy of the sentinel node can be recommended for staging and to facilitate loco-regional control of the disease in patients with T4 melanoma or > 4 mm of Breslow thickness. It is important that the search for the sentinel node is discussed case by case in a multidisciplinary context, taking into account other prognostic variables including age, sex and site of the lesion, which can guide the decision-making process.


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