Our Summary

This study aimed to see if a particular kind of medical scan (lymphoscintigraphy) and a biopsy procedure could be used on patients who had previously had all their lymph nodes removed from a certain area due to cancer, and then developed a new skin cancer (melanoma) in the same area. These patients cannot currently be properly staged for treatment because the lymph nodes that would normally be checked for cancer spread have been removed. The researchers tested this on six patients and found that it was feasible in all cases.

In simple terms, the lymphoscintigraphy scan was used to find the so-called ‘sentinel’ lymph node - the first one that cancer is likely to spread to. A biopsy was then done during surgery with the help of a special dye to remove this node, which was then checked for cancer by a pathologist. Half of the patients had cancer in these nodes.

The researchers concluded that this procedure can safely and effectively be used on patients who’ve had all their lymph nodes removed in the past, allowing doctors to better determine the stage of the cancer and how to treat it. This is crucial information for doctors and it could potentially benefit a small but important group of melanoma patients.

FAQs

  1. What is the purpose of a sentinel lymph node biopsy?
  2. Can a sentinel lymph node biopsy be performed on patients who have previously had all their lymph nodes removed?
  3. How does the sentinel lymph node biopsy procedure work, and how does it help in determining the stage of cancer and its treatment?

Doctor’s Tip

A doctor might advise a patient undergoing a sentinel lymph node biopsy to follow post-operative care instructions carefully to prevent infection and promote proper healing. They may also recommend monitoring for any signs of infection or complications, such as increased pain, redness, swelling, or drainage at the biopsy site. Additionally, the doctor may discuss the importance of regular follow-up appointments to monitor for any signs of cancer recurrence or spread.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with melanoma or other types of skin cancer who have had all their lymph nodes removed in a previous surgery. This procedure is especially useful for patients who cannot be properly staged for treatment due to the removal of their lymph nodes, as it allows doctors to determine the stage of the cancer and plan appropriate treatment.

Timeline

Before the sentinel lymph node biopsy:

  • Patient has previously had all lymph nodes removed from a certain area due to cancer
  • Patient develops a new skin cancer (melanoma) in the same area
  • Patient is unable to be properly staged for treatment due to lack of lymph nodes for testing

After the sentinel lymph node biopsy:

  • Lymphoscintigraphy scan is used to locate the sentinel lymph node
  • Biopsy is performed during surgery to remove the sentinel lymph node
  • Node is checked for cancer by a pathologist
  • Results of biopsy help determine the stage of cancer and appropriate treatment plan
  • Procedure is found to be feasible and effective in determining cancer spread in patients who have had all lymph nodes removed in the past

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and why is it important for melanoma patients who have had all their lymph nodes removed in the past?
  2. How is lymphoscintigraphy used to locate the sentinel lymph node?
  3. What is the process for performing a sentinel lymph node biopsy during surgery?
  4. What are the potential risks or complications associated with a sentinel lymph node biopsy?
  5. How does the presence of cancer in the sentinel lymph node affect treatment decisions for melanoma patients?
  6. How soon after the biopsy will I receive the results and how will they impact my treatment plan?
  7. Are there any specific follow-up care or monitoring steps I should take after undergoing a sentinel lymph node biopsy?
  8. Are there any alternative staging methods or treatments available for melanoma patients who have had all their lymph nodes removed in the past?
  9. How many patients have undergone this procedure and what have been the overall outcomes and success rates?
  10. Are there any ongoing research studies or clinical trials investigating the use of sentinel lymph node biopsy in similar patient populations?

Reference

Authors: Wainstein AJA, Cândido LD, Drummond-Lage AP. Journal: J Invest Surg. 2022 May;35(5):1171-1175. doi: 10.1080/08941939.2021.1986179. Epub 2022 Feb 15. PMID: 35168453