Breslow Thickness and Sentinel Node?

[FlirtDoc]

Any smart person on here know the Breslow thickness needed to get a sentinel node biopsy rather than just wide local excision for melanoma. Is it 0.75 mm?

Also does basal cell and squamous cell have similar cutoffs.

Thank you.

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[sore eye asses]

Any smart person on here know the Breslow thickness needed to get a sentinel node biopsy rather than just wide local excision for melanoma. Is it 0.75 mm?

Also does basal cell and squamous cell have similar cutoffs.

Thank you.

it depends on more than the thickness when it's 0.75-0.99.

BCC and SCC, no.

 

[Dermography]

Not sure if this is the right platform to discuss this, 'cause you've hit on a very controversial topic.

Anyhow, there really isn't a definitive cut off per se. Until we get the next next MSLT interim report, most experts agree on the following for melanoma:

<0.75 mm rarely performed
0.75-0.99 mm depends on pt's risk factors and certain pathologic features
>1 mm usually performed

SLNB is not done on BCC, it's also controversial for SCC and some have argued for performing it but there are no specific guidelines for that

Bear in mind, SLNB has NOT been showed to improve pt's overall survival

D!

 

[pupster]

Any smart person on here know the Breslow thickness needed to get a sentinel node biopsy rather than just wide local excision for melanoma. Is it 0.75 mm?

Also does basal cell and squamous cell have similar cutoffs.

Thank you.

There isn't a lot of data on SLNB on thin melanomas between 0.5 and 0.75 mm. You should review the recent NCCN guidelines as well as the paper from Michigan regarding thin melanomas.

That said, it's debatable whether SLNB is "needed," as studies haven't shown any improvement in mortality w/ SLNB. However, morbidity is a different issue.

Anyway, this sounds a lot like asking for medical advice....so....mod?

 

[asmallchild]

There isn't a lot of data on SLNB on thin melanomas between 0.5 and 0.75 mm. You should review the recent NCCN guidelines as well as the paper from Michigan regarding thin melanomas.

That said, it's debatable whether SLNB is "needed," as studies haven't shown any improvement in mortality w/ SLNB. However, morbidity is a different issue.

Anyway, this sounds a lot like asking for medical advice....so....mod?

OP seems like an IM resident

At my previous institution, we rarely referred for SLNB. With the new medications currently available however, my current group does refer for SLNB more than I am accustomed to. It will be interesting to see whether this will challenge the classic teaching that SLNB does not alter mortality