You may be offered a test called a sentinel lymph node biopsy (SLNB). This may be done even if the lymph nodes aren’t swollen. It’s done at the same time as your wide local excision.
The sentinel nodes are the first ones that lymph fluid drains to from your melanoma. If the melanoma has spread to nearby nodes the sentinel nodes are the ones that are most likely to be affected.
A SLNB can tell your doctors more about the stage of your melanoma. Your specialist will talk to you about whether a SLNB is suitable for you. There are still some questions about the helpfulness of SLNB’s, so they may leave the decision about whether you have one up to you.
Having a sentinel lymph node biopsy
Before your wide local excision, a doctor will inject a tiny amount of a mildly radioactive liquid around the area of your melanoma (where you had your excision biopsy). You will then have a scan to see which lymph nodes the liquid travels to first. These are the sentinel nodes.
Then, during the wide local excision, the surgeon injects a blue dye into the same area as the radioactive liquid. The dye stains the sentinel lymph nodes blue. This helps the surgeon find them and remove them. They are sent to a laboratory and examined under a microscope to see if they contain melanoma cells.
If the sentinel nodes don’t contain cancer cells, it’s unlikely that other lymph nodes are affected so you won’t need to have surgery to remove them.
If they do contain cancer cells, you will be offered further surgery to remove all the lymph nodes near to your melanoma. Your hospital team will discuss with you the benefits and disadvantages of having all the lymph nodes removed.