Our Summary

This study looked at the cost and efficiency of a specific procedure called sentinel lymph node biopsy (SLNB) on patients with a high-risk form of skin cancer, known as thin melanoma. The procedure is recommended to identify whether the cancer has spread to the lymph nodes.

The researchers analyzed data from 70 patients who had surgery for thin melanoma at a tertiary care center between 2009 and 2018. They found that the procedure increased hospital costs and operating time. Despite the increased cost and time, the procedure only identified positive cases in about 6.1% of patients.

In simple terms, the procedure is expensive and time-consuming, but it doesn’t find a lot of positive cases, making it less cost-effective. These findings can be used to better inform discussions between patients and healthcare providers about whether this procedure is the best course of action.

FAQs

  1. What is a sentinel lymph node biopsy (SLNB) and why is it recommended for patients with thin melanoma?
  2. What were the key findings of the study regarding the cost and efficiency of the sentinel lymph node biopsy procedure?
  3. How can the findings of this study about sentinel lymph node biopsy impact the decision-making process between patients and healthcare providers?

Doctor’s Tip

A doctor might tell a patient considering a sentinel lymph node biopsy for thin melanoma that while the procedure can provide important information about the spread of cancer, it may not be necessary for every patient. They may suggest discussing the potential benefits and drawbacks of the procedure with them to make an informed decision about their treatment plan.

Suitable For

Patients with thin melanoma who are at high risk for lymph node involvement are typically recommended sentinel lymph node biopsy. These patients may have a higher chance of the cancer spreading to the lymph nodes, and the procedure can help determine if further treatment, such as lymph node dissection, is necessary. Other factors that may influence the recommendation for SLNB include the size and depth of the melanoma, as well as the presence of ulceration or other high-risk features.

Timeline

Before the sentinel lymph node biopsy:

  1. Patient is diagnosed with thin melanoma, a high-risk form of skin cancer.
  2. Patient discusses treatment options with healthcare provider, including the option of undergoing a sentinel lymph node biopsy.
  3. Patient undergoes pre-operative testing and preparation for the procedure.

After the sentinel lymph node biopsy:

  1. Patient undergoes the procedure, which involves injecting a dye or radioactive substance near the tumor to identify the sentinel lymph node.
  2. The sentinel lymph node is removed and sent to a pathologist for examination.
  3. Patient may experience some discomfort and swelling at the surgical site following the procedure.
  4. Results of the biopsy are communicated to the patient by their healthcare provider.
  5. If the biopsy is negative, the patient may not require further treatment. If positive, further treatment options may be discussed, such as additional surgery or adjuvant therapy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about sentinel lymph node biopsy include:

  1. What are the potential risks and complications associated with the procedure?
  2. How likely is it that the biopsy will identify positive cases of cancer spread to the lymph nodes?
  3. Are there alternative methods of determining if the cancer has spread to the lymph nodes?
  4. How will the results of the biopsy impact my treatment plan?
  5. Are there any specific criteria that make me a good candidate for this procedure?
  6. What is the cost of the procedure and will it be covered by my insurance?
  7. How long will the recovery process be and what can I expect in terms of post-operative care?
  8. Are there any long-term effects or implications of having a sentinel lymph node biopsy?
  9. Can you provide me with any additional information or resources to help me make an informed decision about whether to proceed with the biopsy?
  10. Are there any other questions or concerns I should consider before undergoing this procedure?

Reference

Authors: Aiken TJ, Stahl CC, Schwartz PB, Barrett J, Acher AW, Lemaster D, Leverson G, Weber S, Neuman H, Abbott DE. Journal: J Surg Oncol. 2021 Jan;123(1):104-109. doi: 10.1002/jso.26225. Epub 2020 Sep 16. PMID: 32939750