Online first
Review paper
Published online: 2025-03-27
The actual approach of sentinel node biopsy in cutaneous melanoma
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Abstract
Sentinel lymph node biopsy (SLNB) is a well-established standard of care in melanoma treatment, but its role is evolving. Before the advent of modern systemic therapies, SLNB was critical in identifying which patients would benefit from complementary lymphadenectomy and which would not require this procedure.
Currently, after a positive sentinel node biopsy, lymphadenectomy is no longer performed, altering the procedure's significance. The SLNB identifies patients who will benefit from adjuvant treatment. Additionally, it enhances control over locoregional lymphatic flow. As for now, there is no alternative to sentinel node biopsy.
The gold standard for marking sentinel nodes in melanoma remains the dual radioisotope-dye method, using lymphoscintigraphy and SPECT-CT.
There is ongoing research for new tracers that might replace this method, likely ferromagnetic tracers, which have shown non-inferiority in breast cancer, have not yet proven to be of comparable value in melanoma, due to unpredictable lymphatic drainage, which required preoperative imaging.
Keywords: sentinel node biopsytracersferromagneticradioisotope
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