Sentinel Lymph Node Biopsy

• Nowadays the surgeon does not take all your lymph glands out. Mine took the sentinel node and one either side so there's lots left to drain the lymph.  My melanoma was 3c but even if it had been 1 on the Breslow score I would have gone ahead with the SLNB just to have peace of mind.  I presume if the SLNB is negative you have almost zero chance of recurrence. Good luck with whatever you decide to do x

Hi Kate, 

Same as yours mine was Breslow 1.1mm, non ulcerated and staged as pT2a in histopath report. Sorry, had no mention on mitotic rate or Clark level in mine.

I was offered SLNB and one lymph node was removed for investigation which turned out to be negative and my stage was asserted as 1b.

I have decided to go for SLNB as 1)thought if it was not beneficial would not be offered in the treatment guidelines 2) I was told that I was a low risk of developing lymphadema as only one lymph node was removed, İ am 40 years old,  fit and have no other underlying Condition 3)if turned out to have had metastased,  rather to know early than waiting and finding out later when has spread to other areas 4) if it turned out that I needed immunotherapy etc further down the line, some clinical trials do not accept patients who didn't have SLNB previously. 

As my mole was above my knee, I had to keep my feet elevated for a week and had to wear compression socks for 2 weeks to prevent lymphadema. 

I'd suggest you discuss all findings of your report with your dermatologist and surgeon as not everything in the report has impact on the clinical perspectives /treatment and will help you to understand the risks /benefits. 

Hope this helps. 

Thank you X

My mole was in the same place, just above my knee, and we seem to be on a similar timeline, although I am a month or so behind you. I am the same age as you and also fit and healthy so I hope for the same outcome. Thanks for your reply.

I had a very positive experience overall and hope it all goes well for you. Let me know if you have any questions down the line. 

Hi Kate

My story is similar to yours but I'm still waiting to see surgeon. I was diagnosed 1b 3 weeks ago. Mine was slightly thicker at 1.8mm also above my knee. DIdn't ask about mitotic rate but like you mine changed quickly over the 6 weeks (yep 6 weeks not the 2 I was told) between referral and biopsy. I am still undecided whether to go for the slnb until I talk to them. I am older at 59. I'm not that worried about the lymphodema  as reading everyone's comments on here it doesn't sound that usual. The one thing that will make me decide is like all of you say its a peace of mind thing. But my one question is if they don't find any in the node (please hopefully!) Does that mean it will not be found in the Node ever or is it just it was not found in there on the day they do it? By having one removed I'm guessing that's no guarantee it'll appear in a neighbouring one down the line?

The other thing on mind is my biopsy incision became infected which I had antibiotics for but it meant if took longer for healing. I am exactly 2 months on from the day they did it and it is only the last few days I can say I feel my leg is back to normal. Its been not exactly painful after the infection cleared but it has taken quite a time.I still have a purple scar with all the stitch hole marks. The consultant has checked it and says its fine. My skin takes ages to heal and I scar badly. I once got bitten on my legs by midges in August, I still had red welts the size of 5p pieces 6 months later! So I know the WLE is maybe going to be a longer road and not looking forward to more trouble with an SLNB added in! I'm normally very active so prepared yo be a couch potato for a while! 

It's hard not knowing if the decision uou make is right or not x

Yes I think it can come back in the lymph nodes and so you have to keep doing your monthly checks. It's staging not treatment, is my understanding, so the SLNB is to give information on prognosis only. And I guess you are able to start treatment sooner if they do find cancer cells there.

It's almost like I feel completely normal and fine and I don't want to be cut up again - like you I got an infection from the initial mole removal surgery. I work in a manual job which I enjoy, and I am concerned about getting back into it again with all the lifting and carrying I do all day. I think I started lifting too soon last time and I got a haematoma that then became infected.

But I will find out more next week and ask about why they think it's a good idea specifically for me and I hope that will make it easier to decide.

Kate x

Hi Kate, 

Just wanted to add that my SLNB cut on my groin is 3cm long and almost healed now at week 5. Compared to WLE cut is doing much better. I was told no heavy lifting, swimming, running etc for 6 weeks. 

Yes I'm in a manual job too. I'm a catering manager in a very large primary school on my feet from 7.30 till 2. Like you lifting carrying etc. Plus I like to walk to school for fitness. I'm guessing we will be told we can't do all that for a while. I'm fine with that as I just want to get it done and hopefully find out everything is fine. I'm keeping anything good to watch on tv/films for when I'm confined to a chair lol! I'm also going to ask what the likelihood of another infection may be as well and if they can give me a prescription ready in case. The one I had happened over the August Bank Holiday and I couldn't get one till the Tuesday even out of hours were not helping. I'd rather nip it in the bud. Let's hope we both escape that this time x

Hi JannAA, 

Sorry your wait was longer than usual. 

Some info regarding SLNB as I've asked similar Q to my surgeon:

They inject a dye to find out the route cells follow in the lymphatic system from the mole to the sentinel node, on the day or day before the surgery. Than scan the area to see which particular lymph node is illuminated by the dye. My mole was on my knee so they've expected to see the dye going to either lymph nodes on the groin or behind the knee. Removing the stained sentinel node means if there were any cells transferred previously they would have been removed. There is a tiny possibility for the satellite cells from the tumor that remain outskirts of the WLE, might be transferred to another node but my surgeon said it is very very minimal and its not something she's seen before in stage 1b patients.

For scar healing I am using silicone gel Kelo-cote and I am amazed how well it healed even after 5 weeks, so would suggest you to give it a try.