New guidelines issued for biopsy use in melanoma patients

July 9, 2012
New guidelines issued for biopsy use in melanoma patients
Expert panel said sentinel lymph node biopsy to show if cancer has spread could be used more consistently.

(HealthDay) -- Sentinel lymph node biopsy -- a minimally invasive surgical technique that lets doctors see whether cancer has spread -- should be performed on patients with melanoma tumors of intermediate thickness and may also be appropriate for thick melanoma tumors, according to new guidelines released Monday.

The American Society of Clinical Oncology (ASCO) and the Society for issued the evidence-based recommendations to clarify the use of this type of biopsy, which they said has been inconsistent.

A sentinel lymph node is the first lymph node to which are most likely to spread from the original tumor, according to the U.S. . There can be more than one sentinel lymph node. During a biopsy, the node is identified, removed and examined for cancer cells.

"When used for the right at the right time, is one of our best tools for personalizing treatment, and for sparing patients from unnecessary procedures or therapies," study lead author Dr. Sandra Wong, co-chair of the guideline panel and an assistant professor of surgery at the University of Michigan, said in an ASCO news release.

The panel of 14 clinical and methodological experts from various disciplines reviewed 73 studies, involving 25,000 patients, that were published over the past two decades. After examining this evidence, the panel made the following recommendations:

  • The procedure is recommended for all patients with melanoma tumors between 1 millimeter (mm) and 4 mm (intermediate thickness). Sentinel lymph detects cancer in the sentinel node in about 18 percent to 26 percent of these patients, the panel noted.
  • Sentinel lymph node biopsy may be beneficial to patients with melanoma tumors greater than 4 mm ("thick"). The panel noted, however, that few studies focus on the use of the biopsy in patients with thick melanomas.
  • The panel found there is not enough evidence to recommend routine sentinel lymph node biopsy for patients with melanoma tumors less than 1 mm ("thin"). The experts added that thin melanomas can usually be cured through surgical removal of the primary tumor. However, the biopsy could be considered in patients with thin melanoma who have certain high-risk factors, such as rapidly dividing cancer cells.

Patients with a positive sentinel lymph node biopsy should undergo complete removal of the remaining , the experts added. This procedure has been shown to prevent the spread of cancer.

The panel also advised doctors to discuss sentinel lymph node biopsy, particularly the procedure's potential risks and benefits, with their patients as part of the treatment-planning process.

"Our rapidly growing understanding of the biology of melanoma is driving development of more effective treatments with fewer side effects for patients," panel co-chair Dr. Gary Lyman, a professor of medicine and director of comparative effectiveness and outcomes research at Duke University School of Medicine and the Duke Cancer Institute, said in the news release.

"But to take advantage of this progress, we need to know the true extent of the disease from the start. This guideline will help ensure that biopsy is used appropriately whenever it can provide that vital information while avoiding unnecessary procedures in patients who are unlikely to benefit."

Information on the guidelines was published online by ASCO.

Explore further: Sentinel node biopsy safe, effective in head and neck melanomas

More information:
The U.S. National Cancer Institute has more about melanoma.


Related Stories

Sentinel node biopsy safe, effective in head and neck melanomas

August 5, 2011
A common technique for determining whether melanoma has spread can be used safely and effectively even in tumors from the head and neck area, according to a new study from the University of Michigan Comprehensive Cancer Center.

Breast cancer patients with positive ultrasound guided axillary node biopsy need dissection

May 3, 2012
Contrary to a trend in treatment, breast cancer patients with suspicious lymph nodes should have an ultrasound-guided axillary node biopsy, and if that biopsy is positive these patients should undergo an axillary dissection, ...

Sentinel lymph node biopsy predicts outcomes for Merkel cell carcinoma

October 3, 2011
Patients with Merkel Cell Carcinoma who underwent a procedure called sentinel lymph node biopsy (SNLB) had a lower risk of cancer recurrence after two years, according to a study by researchers from Fox Chase Cancer Center. ...

Recommended for you

How a non-coding RNA encourages cancer growth and metastasis

August 21, 2017
A mechanism that pushes a certain gene to produce a non-coding form of RNA instead of its protein-coding alternative can promote the growth of cancer, report researchers at the Medical University of South Carolina (MUSC) ...

Spaser can detect, kill circulating tumor cells to prevent cancer metastases, study finds

August 21, 2017
A nanolaser known as the spaser can serve as a super-bright, water-soluble, biocompatible probe capable of finding metastasized cancer cells in the blood stream and then killing these cells, according to a new research study.

Comprehensive genomic analysis offers insights into causes of Wilms tumor development

August 21, 2017
A comprehensive genomic analysis of Wilms tumor - the most common kidney cancer in children - found genetic mutations involving a large number of genes that fall into two major categories. These categories involve cellular ...

Comparison of screening recommendations indicates annual mammography

August 21, 2017
When to initiate screening for breast cancer, how often to screen, and how long to screen are questions that continue to spark emotional debates. A new study compares the number of deaths that might be prevented as a result ...

Vitamin C may encourage blood cancer stem cells to die

August 17, 2017
Vitamin C may "tell" faulty stem cells in the bone marrow to mature and die normally, instead of multiplying to cause blood cancers. This is the finding of a study led by researchers from Perlmutter Cancer Center at NYU Langone ...

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.