(Screening and) Surveillance Ultrasound of Nodes in Melanoma
A study of ultrasound surveillance of regional lymph nodes after resection of primary cutaneous melanoma" class="alignnone"/>
Evidence forms the backbone of good medical practice, it’s time for evidence based surveillance of melanoma patients too
Sentinel Node Biopsy is an effective and accurate staging tool with the ability to detect very small (microscopic) melanoma metastases to the lymph nodes. However, it is an invasive operation with well documented side effects and has never been demonstrated to offer a survival advantage to patients. In spite of the current lack of clinical trial evidence, sentinel node biopsy is frequently offered to patients wishing to enter adjuvant trials as a gold standard staging modality.
Previously, clinical examination alone has been thought to be the main alternative meaning that only lymph nodes containing sufficient tumour to be palpably enlarged were detected.
Ultrasound (US) offers a number of advantages over both of these methods, offering high resolution to detect smaller than palpable nodal metastases without the invasive nature of sentinel node biopsy. Additionally, should a suspicious node be detected, a minimally invasive fine needle aspiration procedure (similar to a blood test) can be performed. The cells gathered are sent to a histopathologist for cellular and molecular examination.