The Role of Sentinel Lymph Node Biopsy in Thin Melanoma (Breslow Thickness ≤ 0.75 mm and 0.76 mm - 1.0 mm Respectively): Our Results and Review of the Literature

Introduction: The Sentinel Lymph Node Biopsy (SLNB) in melanoma is animportant tool of staging. The impact on overall survival still remainsunclear. The guidelines in regard to depth, taking in mind where SLNB stagingbenefits do not outweigh the risks of the procedure, are constantly reviewedand modified. Patients and Methods: From 2010 to 2015, 104 patients with thinmelanoma Stage IA with presence of adverse or high risk features and from IBonly TIb, N0, M0 (American Joint Committee on Cancer, AJCC Melanoma Staging andClassification 7th Edition 2009) were included and divided into 2groups: Group A: 68 patients with Breslow ≤ 0.75 mm and Group B: 36 patientswith Breslow 0.76 - 1.0 mm. Initially all patients underwent excision of theprimary site and subsequently wide local excision and SLNB. We analyzed thehistopathology reports of SLNB procedures in both groups. Results: There was nopositive SLN in group A (0%). 4 patients from group B had positive SLN (11.1%)and underwent Completion Lymph Node Dissection (CLND). The total percentage ofpositive SLNs from both groups was 3.8%. Conclusions: Our findings justify theSLNB procedure in thin melanomas of 0.76 - 1.0 mm. In melanomas ≤ 0.75 mm, SLNBshould be considered on an individual basis when “high-risk features” arepresent. More comparable studies should be evaluated in order to accuratelydefine the threshold value of Breslow thickness where SLNB is safely deemedunnecessary.