The sentinel lymph node biopsy is done after the biopsy of the melanoma but before the wider excision of the tumor. In a sentinel lymph node biopsy, a radioactive substance is injected near the melanoma. The surgeon then follows the movement of the substance on a computer screen. The first lymph node to take up the substance is called the sentinel lymph node. The imaging study is called lymphoscintigraphy, and the procedure used to identify the sentinel node is called sentinel lymph node mapping. The surgeon will then remove the sentinel node to check for cancer cells. If a sentinel node contains cancer cells, the surgeon will remove the rest of the lymph nodes in the area. However, if a sentinel node does not contain cancer cells, no additional lymph nodes are removed.

 

In a lymph node dissection, the surgeon will remove all of the lymph nodes in the area of the melanoma. Therapy may be given after surgery to kill any remaining cancer cells. This treatment is called adjuvant therapy. The patient may also receive biological therapy.

 

Limitations of Surgery for Melanoma