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
  • Not exactly on topic but my husband has been.diagnosed with Merkel cell carcinoma on his scalp After  a pet scan something showed in 2 lymph nodes neck Im assuming you like me are a proud Mancunion apologises if I'm not correct Our consultant advised a fine needle biopsy to check if the something was cancer It was and on Monday he is having a pre op.and a  consultation with the anesthetist to check that at 81 with atrial fibulation he's OK for general anaesthetic and possibly 5 hour surgery Surgery will involve removal of 2 lymph nodes the tumour and plastic surgery If its a no no tumour will.be removed but he will have radiotherapy which our consultant says is very effective When we meet him next week I'm going to raise lymph node removal versus radiotherapy I need to be sure that my husband gets the best treatment given his particular circumstances I can't stand by and accept without ensuring I have all the pros and cons

    Best wishes 

    Celia

  • Hi Celia. Tough dealing with such news, and I wish you and your husband well. There are limits to what doctors can do, but I am confident they will be giving the best advice they have; as you will see from this thread/topic, there are no absolute answers, there is just considered judgement given the current limitations of our knowledge.  Good for you to be involved, another brain considering the options is always beneficial. Best wishes, Paul

  • Thanks I woke up at 4am and the reality has hit and I'm shaking Hubby is fast asleep I'm going to make a drink and try some yoga meditation  

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