Is 1 mm thickness sec. Breslow the correct cut-off for sentinel node biopsy in melanoma? Report of six cases of metastasis by thin melanoma.

Aim: To reassess selection criteria for Sentinel Lymph Node Biopsy (SLNB) in patients with thin melanoma (Breslow ≤ 1 mm).

Material Of Study: Between January 2004 and November 2010 we observed 6 patients with lymph node metastasis from early melanoma (Breslow ranging from 0.3 mm to 0.9 mm, not ulcerated tumor, mitosis/ mmq < 1). Nobody had received a prior study of sentinel lymph node so all patients underwent enlarged lymphadenectomy of concerned lymphatic stations and cancer re-staging.

Results: The pathological examination of lymph nodes has always confirmed metastatic melanoma. The average followup is currently 51,5 months: 3 of 6 patients presented recurrence that in one case led to death.

Discussion: In the event of a thickness < 1 mm the probability of finding a positive sentinel lymph node is about 7%. Recent data have demonstrated a significant survival advantage to early therapeutic lymphadenectomy in melanoma.

Conclusions: Our experience, supported by the cases described and the literature, leads to propose the technique of SLNB to all patients with melanoma thicker than 0.5 mm, given the low morbidity and the important prognostic role of the procedure, in addition to the possibility of reducing the incidence of lymph node metastases.