Choice of Sentinel Lymph Node Biopsy

Historically, in 2009 I had a Stage 1 0.3mm Malignant Melanoma removed from my right leg, followed by a Wide Local Excision (WLE).  No recurrence of Melanoma until now.

I have recently been diagnosed with a Stage 1B 1.3mm Malignant Melanoma on my upper left back and am currently scheduled to have a further WLE and Sentinel Lymph Node Biopsy (SNB).

During my post diagnosis review with the specialist Doctor, I understood that the SNB is a diagnostic procedure and optional.  I did ask at the time what the outcomes and treatments would be if deciding or not to have the SNB, but understandably the Doctor explained the various factors were too complex to provide a relevant answer.

Following the review with the Doctor, a nurse followed up and checked I had understood what had been discussed, and gave me a leaflet on SNB.

Following that, I read the leaflet, that confirmed the SNB was a diagnostic procedure which facilitates improved staging, but stated that SNB ‘has no proven survival benefit’.  I have followed up on this statement with the Cancer nurses, and had a telephone conversation with the Doctor who undertook the diagnosis review.  I ask, as all surgery has risk, why undertake a SNB which 'has no proven survival benefit'.  I have not had an answer which makes sense to me, and I continue to be advised that the SNB is optional.

What I am trying to understand is, based on experience, out of say 100 Stage 1B patients who undertake SNB, what is the 5 year survival rate compared with a separate 100 Stage 1B patients who choose not to have the SNB?  If I understand the statement 'has no proven survival benefit' correctly, there is no difference in 5 year survival rate.  My logic therefore is to not take any risk (even if small) with the SNB.

Is my logic or understanding faulty?

Parents
  • Hello and many thanks for your post,

    I am sorry to learn of your situation, this must be a difficult time.

    You may have seen this already, we have information about sentinel node biopsy (SNLB) which includes the advantages and disadvantages.

    Some patients with 1B melanoma will be offered a SNLB depending on the size of the melanoma and whether there are risk factors that the cancer may have spread such as if there is broken skin on the melanoma (ulcer), if there are cancer cells in the lymph vessels or blood vessels of the melanoma or if the cells are dividing quickly.   

    The role of sentinel node biopsy remains optional because it is not seen as a treatment. Although there is no evidence that this procedure improves overall survival from the disease it will provide more information about the melanoma and give doctors more guidance about what may happen. If you did have the test done and it was found the node was found to have cancer cells, this will change the stage of the melanoma to stage 3 which means you could have adjuvant treatment, to reduce the risk of the melanoma coming back.

    A positive lymph node is found in 1 in 5 people (20%) who have the procedure done. You can read more about this on the Melanoma Focus website, they also have a helpline that you can contact at 0808 801 0777. 

    I know you have already spoken with your specialist, but it may be worth having another chat with them as they know your situation and will be able to give you more clarification about what was found when they did the biopsy.

    I hope this helps a little. Please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care all the best,

    Jemma

Reply
  • Hello and many thanks for your post,

    I am sorry to learn of your situation, this must be a difficult time.

    You may have seen this already, we have information about sentinel node biopsy (SNLB) which includes the advantages and disadvantages.

    Some patients with 1B melanoma will be offered a SNLB depending on the size of the melanoma and whether there are risk factors that the cancer may have spread such as if there is broken skin on the melanoma (ulcer), if there are cancer cells in the lymph vessels or blood vessels of the melanoma or if the cells are dividing quickly.   

    The role of sentinel node biopsy remains optional because it is not seen as a treatment. Although there is no evidence that this procedure improves overall survival from the disease it will provide more information about the melanoma and give doctors more guidance about what may happen. If you did have the test done and it was found the node was found to have cancer cells, this will change the stage of the melanoma to stage 3 which means you could have adjuvant treatment, to reduce the risk of the melanoma coming back.

    A positive lymph node is found in 1 in 5 people (20%) who have the procedure done. You can read more about this on the Melanoma Focus website, they also have a helpline that you can contact at 0808 801 0777. 

    I know you have already spoken with your specialist, but it may be worth having another chat with them as they know your situation and will be able to give you more clarification about what was found when they did the biopsy.

    I hope this helps a little. Please get back to us if you need any more information or support.  You may find it helpful to talk things through with one of the nurses on our helpline.  The number to call is Freephone 0808 800 4040 and the lines are open from 9am till 5pm Monday to Friday.

    Take care all the best,

    Jemma

Children
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