Sentinel Node Mapping for Patients with Facial Melanoma

A study has found that patients who develop melanoma on their face, head, or neck can have the same early-diagnosis surgical procedure, sentinel node mapping, as patients whose cancer is on less delicate areas of the body. The study was published in the January 2003 issue of the Archives of Otolaryngology.

Sentinel node mapping shows if cancer cells have entered nearby lymph nodes and might spread further. Many hospitals use the procedure on patients with melanoma lesions on their arms, trunk, or legs. Previously, fear of damaging delicate nerves and blood vessels had prevented doctors from using the technique on patients with cancer on their scalp, face, or neck. In a study of 80 patients, more than 96% were successfully mapped, and 18% were shown to have melanoma that had spread to a lymph node, giving them an earlier diagnosis than a routine examination would have provided. The false-negative rate was 4.5%.

In the mapping procedure, also called sentinel node biopsy, a radioactive tracer and blue dye are injected near the melanoma site. A handheld radiation sensor shows where the radioactivity has concentrated. A surgeon can then make a tiny incision there and look for signs of blue dye entering the first lymph node or nodes. This tells the doctors which nodes should be removed for testing.

"Although the technique is most challenging in these patients, we now know it can be done, and done safely,” said Carol Bradford, M.D., co-author of the study and associate professor at the University of Michigan Medical School (Ann Arbor, USA). "Based on these results and other studies, we hope that sentinel lymph node mapping becomes part of standard practice for all patients with melanoma more than 1 mm in depth.”




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University of Michigan Medical School