Sentinel lymph node biopsy
SLNB helps detect microscopic regional nodal involvement and refine pathological staging in clinically node-negative melanoma.
What it is
Sentinel lymph node biopsy (SLNB) is a regional staging procedure. The sentinel node is the first lymph node, or group of nodes, receiving lymphatic drainage from the primary melanoma site.
When it is discussed
Current European guidance supports offering SLNB for melanoma with a Breslow thickness of at least 1.0 mm. For tumours 0.8–1.0 mm, or thinner melanomas with ulceration, the procedure should be discussed individually; additional histological risk factors may also influence the decision. Routine SLNB is not recommended for pT1a melanoma (<0.8 mm without ulceration).
How the procedure is performed
- Lymphatic mapping is performed using an appropriate tracer or marker to identify the sentinel node basin.
- During surgery, the sentinel node is identified using dedicated detection equipment and removed through a separate small incision.
- The node is then examined pathologically, with immunohistochemistry where appropriate.
Short operating-room video
This short video shows one step of the procedure — device-guided identification and removal of the sentinel lymph node.
What the result is used for
The main purpose of SLNB is staging and prognostic assessment. Detection of melanoma in the sentinel node confirms pathological regional nodal involvement and may alter subsequent surveillance, imaging and systemic treatment planning.
What a positive result does not automatically mean
A positive sentinel node does not automatically mandate completion lymph node dissection. Contemporary management depends on nodal tumour burden, stage, ultrasound surveillance options and the overall systemic treatment plan.
Our research
In 2023, Vasyl Ostafiichuk co-authored a study of long-term outcomes after SLNB in 309 patients with melanoma. The findings supported the primarily diagnostic and staging role of the procedure; overall survival did not differ significantly between study groups.
- ESMO Clinical Practice Guideline: Cutaneous melanoma — diagnosis, treatment and follow-up.
- European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment — Update 2024.
- Kukushkina M, Korovin S, Solodiannikova O, Sukach G, Ostafiichuk V, Dedkov S. Long-term outcomes of sentinel lymph node biopsy versus lymph node observation in melanoma patients. 2023;28:513–518.
General information only. The decision to perform SLNB requires review of the complete pathology report and the individual clinical situation.