Our Summary

This research paper is about a specific type of skin cancer, called desmoplastic melanoma. The researchers are trying to figure out if a certain procedure, called a sentinel lymph node biopsy, is always necessary for patients with this type of cancer.

They looked at a bunch of previous studies from 2001 to 2019, which included almost 4,000 patients. They found that this procedure was done in over half of these patients and found cancer in the lymph nodes in about 8.5% of them.

However, they saw that patients with a specific subtype of this cancer, called pure desmoplastic melanoma, had a much lower rate of cancer spreading to the lymph nodes compared to another subtype, mixed desmoplastic melanoma (4.9% vs 14.8%).

So, they concluded that it’s very important for doctors to clearly identify the subtype of desmoplastic melanoma a patient has. They recommend strongly considering this procedure for patients with mixed desmoplastic melanoma. However, for patients with pure desmoplastic melanoma, they suggest that the low rate of cancer spread might not be high enough to justify the procedure.

Previously, it was thought that this type of cancer was less likely to spread to the lymph nodes compared to other types of skin cancer. This study indicates that it’s important to identify the subtype of desmoplastic melanoma to decide if a biopsy is needed.

FAQs

  1. What is the purpose of a sentinel lymph node biopsy in desmoplastic melanoma patients?
  2. How does the subtype of desmoplastic melanoma affect the likelihood of cancer spreading to the lymph nodes?
  3. Why might the sentinel lymph node biopsy not be recommended for patients with pure desmoplastic melanoma?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to make sure they understand the importance of identifying the specific subtype of their cancer. In the case of desmoplastic melanoma, knowing whether it is pure or mixed can help determine if the biopsy is necessary. It’s important for patients to ask their healthcare provider about the subtype of their cancer and discuss whether a sentinel lymph node biopsy is recommended based on their individual situation.

Suitable For

Therefore, patients with desmoplastic melanoma, especially those with the mixed subtype, are typically recommended for sentinel lymph node biopsy to determine if the cancer has spread to the lymph nodes. For patients with pure desmoplastic melanoma, the decision to undergo this procedure should be made on a case-by-case basis, taking into consideration the low rate of cancer spread in this subtype.

Timeline

Before the sentinel lymph node biopsy:

  • Patient is diagnosed with desmoplastic melanoma
  • Patient undergoes various tests and evaluations to determine the extent of the cancer
  • Doctor recommends a sentinel lymph node biopsy based on the subtype of desmoplastic melanoma

After the sentinel lymph node biopsy:

  • Procedure is performed to determine if cancer has spread to the lymph nodes
  • Results show whether cancer cells are present in the lymph nodes
  • Doctor uses these results to determine the best course of treatment for the patient based on the subtype of desmoplastic melanoma
  • Patient may undergo further treatment or monitoring based on the biopsy results.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and how is it done?
  2. What are the potential risks and complications associated with a sentinel lymph node biopsy?
  3. How will the results of the biopsy impact my treatment plan?
  4. Are there alternative methods for determining if the cancer has spread to the lymph nodes?
  5. How do you determine if I have pure desmoplastic melanoma or mixed desmoplastic melanoma?
  6. Based on my subtype of desmoplastic melanoma, do you recommend a sentinel lymph node biopsy?
  7. What are the chances of cancer spreading to the lymph nodes for my specific subtype of desmoplastic melanoma?
  8. Are there any specific factors about my case that make a sentinel lymph node biopsy more or less necessary?
  9. How will the results of the biopsy affect my prognosis and long-term outcomes?
  10. Are there any additional tests or procedures that I should consider in conjunction with a sentinel lymph node biopsy?

Reference

Authors: Hodson M, Feustel P, Davis L. Journal: J Plast Reconstr Aesthet Surg. 2022 Dec;75(12):4441-4449. doi: 10.1016/j.bjps.2022.08.044. Epub 2022 Aug 28. PMID: 36283925