Pain and / or discomfort at the site of the incision.The side effects which might accompany a sentinel node biopsy may include the following. The sentinel node information is essential for accurate staging and potential access to adjuvant treatment drugs (anti-PD1 or BRAF/ME inhibitors). If melanoma cells are found to be present in a sentinel lymph node then management has now changed to observation with ultrasound instead of surgery in most cases (depends on size of melanoma deposit). Blue and “hot” sentinel node(s) which are identified will be surgically removed and sent to the Pathology Department for examination. An incision is made in the regional lymph node area(s) identified by the pre-operative lymphoscintigram. The sentinel node biopsy is performed in the operating theatre at the same time as the wide local excision (the surgical removal of additional skin and tissue around the site of the primary melanoma). This test cannot be done as accurately after you have had a wide local excision because the surgery will disrupt the natural lymph drainage pathways from the melanoma site. If crosses have been marked on your skin, please try NOT to wash them off. The location of lymph nodes identified as “sentinel” nodes – the first nodes on the lymph drainage pathways – will be marked on the skin with indelible ink either in the form of little crosses or tattoos. Firstly because the dose is so small and secondly because it loses its radioactivity very quickly. Although the tracer is radioactive, there is no significant risk to you from its use. Scans are done immediately and 2-3 hours later. The tracer moves through the skin’s lymphatic channels and special scans are performed to determine the regional lymph node area to which drainage occurs. HOW IS IT DONE?Ī tiny dose of radioactive tracer is injected into the skin around the site of the primary melanoma. This regional lymph node field might be at risk for containing metastatic disease. The purpose of the test is to accurately identify the location of the lymph nodes that drain the skin around the melanoma.
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