The document discusses recommendations from ASCO for sentinel lymph node biopsy and management of regional lymph nodes in melanoma patients. It recommends that SLN biopsy is not needed for thin melanomas less than 0.8mm thick without ulceration. SLN biopsy may be considered for lesions between 0.8-1mm thick or less than 0.8mm thick with ulceration after discussing risks and benefits with the patient. SLN biopsy is also recommended for thick melanomas over 4mm thick after discussing risks and benefits. If the SLN biopsy is positive, completing lymph node dissection is an option.

1. Sentinel Lymph Node Biopsy and
Management of Regional Lymph
Nodes in Melanoma
Dr. Ahmed Mjali
Hematology / Oncology

2. ASCO recommendation
1. Thin melanomas that are T1a (non ulcerated lesions <
0.8 mm in Breslow thickness) SLN not recommended.
2. < 0.8 mm Breslow thickness with ulceration ,
lymphovascular invasion or high mitotic rate SLN may be
recommended.
3.SLN biopsy may be considered for thin melanomas that
are T1b (0.8 to 1.0 mm Breslow thickness) after a
thorough discussion with the patient of the potential
benefits and risk of harms associated with the procedure.

3. 4.SLN biopsy may be recommended for patients with
thick melanomas (T4; > 4.0 mm in Breslow
thickness), after a discussion of the potential
benefits and risks of harm.
5. In the case of a positive SLN biopsy complete
lymph node dissection (CLND) can be offered.

5. Thank you