In addition to the surgical removal of melanoma, biopsies of other areas may be needed, such as a lymph node biopsy, to determine if the melanoma has spread. Dr. Patel, can you tell us about lymph node biopsies?
Certainly, Dr. Mayzik. Sentinel lymph node biopsy is a staging tool, which offers valuable prognosis and treatment information. A sentinel lymph node is the first lymph node to which cancer cells are most likely to spread from a primary tumor.
To find the sentinel lymph node or nodes and perform the biopsy, a small amount of radioactive material, and sometimes a contrast material, are injected into the vicinity of the tumor. Then various lymph node areas are checked with a radioactivity detector, which works like a Geiger counter, to locate the sentinel lymph node or nodes.
A small incision is then made in the identified lymph node area and the nodes are checked to find those that changed color or became radioactive. When the sentinel node has been found, it’s removed and sent to a pathologist for review. If the sentinel node reveals melanoma, additional lymph nodes from the surrounding area are removed and tested.
After any biopsy, a sample is usually sent to the lab for review. It’s looked at under a microscope for diagnosis and to see if further tests are required.