Being diagnosed with melanoma can feel overwhelming, especially when you’re suddenly faced with decisions about tests and treatments you’ve never heard of before. One of the most common discussions for people with Stage I or Stage II melanoma is whether to have a sentinel lymph node biopsy (SLNB).
While it may sound daunting, understanding what the procedure involves, why it’s recommended, and what information it can provide can help you make a more informed decision alongside your healthcare team.
A sentinel lymph node biopsy is a surgical procedure used to determine whether melanoma has spread beyond the original tumour site.
The sentinel lymph node is the first lymph node that drains fluid from the area where the melanoma developed. If melanoma cells begin to spread through the lymphatic system, this is usually the first place they are likely to travel.
By removing and examining this lymph node under a microscope, doctors can determine whether microscopic melanoma cells are present.
The main purpose of a sentinel lymph node biopsy is to provide more accurate staging information.
For patients with thicker melanomas or other higher-risk features, the procedure can help answer an important question, has the melanoma started to spread beyond the skin? A sentinel lymph node biopsy can:
However, it’s important to understand that the procedure is primarily a staging tool. Current evidence does not show that removing the sentinel lymph node itself improves overall survival.
A sentinel lymph node biopsy is typically discussed for patients with:
Your specialist will consider several factors, including:
Every person’s situation is different, and the decision is often made through a shared discussion between the patient and their treating team.
How is a Sentinel Lymph Node Biopsy Performed?
Before the operation, patients undergo a special imaging test called a lymphoscintigraphy scan.
A small amount of radioactive tracer is injected near the melanoma site. This allows specialists to map where the lymphatic fluid travels and identify the sentinel node.
In many centres, this is performed on the morning of surgery or the day beforehand.
During the operation:
Most patients only have one or two sentinel nodes removed, rather than an entire lymph node basin.
After Surgery the lymph nodes are sent to a pathology laboratory where they undergo detailed examination.
Results are usually available within one to two weeks.
What Do the Results Mean?
A Negative Sentinel Node means no melanoma cells are found, this is reassuring news.
Patients with a negative sentinel node generally have a lower risk of recurrence and often remain classified as Stage I or Stage II melanoma.
A Positive Sentinel Node means melanoma cells are detected, the melanoma is upstaged to Stage III disease.
This information may open the door to additional treatments designed to reduce the risk of recurrence, including:
A sentinel lymph node biopsy is not mandatory, it is a choice for the patient.
Potential Benefits and Risks of a Sentinel Lymph Node Biopsy
The decision involves weighing:
Potential Benefits
Potential Risks
Many patients find value in having additional information, while others decide against the procedure and instead choose ongoing monitoring.
Patients who do not proceed with a sentinel lymph node biopsy are still monitored carefully.
This often includes:
Ultrasound is considered an effective way to monitor lymph nodes over time and may be recommended every few months during the initial years after diagnosis.
Most people recover well following sentinel lymph node biopsy.
However, some temporary side effects are common, including:
Depending on where the biopsy was performed, patients may need to modify physical activity for a short period.
For example:
For many people, the hardest part of the process is waiting for pathology results.
The period between surgery and receiving results can bring significant anxiety and uncertainty.
It’s important to remember that:
During this period, many patients find it helpful to lean on family, friends, support groups, nurses and melanoma support organisations.
At age 27, Gold Coast resident Ella was diagnosed with a 1.4mm nodular melanoma on her thigh.
When discussing treatment options with her specialist, she was given the choice of whether or not to proceed with a sentinel lymph node biopsy.
After asking questions and considering the information carefully, she chose to have the procedure because she wanted greater certainty about whether the melanoma had spread.
One lymph node was removed from her groin and, thankfully, the results showed no evidence of melanoma.
Although she later developed a seroma (a collection of fluid) that required drainage, she recovered well and continues regular follow-up appointments, skin checks and imaging.
Looking back on her experience, Ella says the procedure provided valuable clarity and confidence at a time filled with uncertainty.
A sentinel lymph node biopsy is an important staging procedure that helps determine whether melanoma has spread to nearby lymph nodes.
While it does not guarantee improved survival on its own, it provides critical information that can guide treatment decisions and identify patients who may benefit from additional therapies.
If you’re considering a sentinel lymph node biopsy:
Most importantly, remember that this decision is personal. The right choice is the one that aligns with your individual circumstances, values and treatment goals after a thorough discussion with your specialist team.
Whether you’re newly diagnosed, undergoing treatment, recovering from surgery, managing side effects, or adjusting to life after treatment, support is available.Â
Melanoma Nurses work alongside healthcare teams to ensure patients receive not only expert clinical care but also the emotional, practical, and informational support needed to navigate the challenges of melanoma.Â
If you or a person you care for has been affected by melanoma, consider speaking with your healthcare team about available nursing support or contacting Melanoma Patients Australia to learn more about its free specialist Telehealth Nurse Service.Â
Like this blog? Head to Melanoma Patients Australia News & Events to read more.Â
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