Lymphatic mapping and sentinel lymph node biopsy (SLNB)

Lymphatic mapping and SLNB have assessed the presence of occult metastasis in the regional lymph nodes of patients with stage II disease. These procedures may identify individuals who can avoid regional lymph node dissection and individuals who may benefit from adjuvant therapy.[5-9]

To ensure accurate identification of the sentinel lymph node, lymphatic mapping and removal of the sentinel lymph node are performed during the same operation as the wide excision of the primary melanoma.

With the use of a vital blue dye and a radiopharmaceutical agent injected at the site of the primary tumor, the first lymph node in the lymphatic basin that drains the lesion can be identified, removed, and examined microscopically. Multiple studies have demonstrated the diagnostic accuracy of SLNB, with false-negative rates of 0% to 2%.[5,10-14]