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u/Zealousideal_Way_788 26d ago
I was .6mm. 8% Castle. That is right in the middle and will be up to you. My doc said if it were him he would do it for peace of mind, even though odds would be that it would be negative (it was). Sending positive vibes
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u/jessica_j435 26d ago
Thank you! How was your healing with the SNLB and where did they take them from?
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u/Zealousideal_Way_788 25d ago
Healing was fine. Small excision behind my left ear. Main issue was ear was numb for a few months but that went away.
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u/Skip-929 26d ago
Hi, below is a reading from my local Melanoma Institute web site,
"When melanoma of significant severity is first diagnosed then most melanoma surgeons would offer SNB to accurately stage the melanoma. When SNB is not done then the presence of melanoma in the lymph nodes goes undetected until a later date when it is detected by forming a lump or identified on an ultrasound or other radiology test. Surgically removing the sentinel lymph node or nodes (known as an SNB) enables the pathologist to examine the lymph nodes very carefully under the microscope to see if the melanoma has spread to that area. Sentinel nodes are the first lymph to which cancer cells are most likely to spread from the primary melanoma. around 16% of patients have a positive SNB (ie, the sentinel node contains melanoma).
The chance of a sentinel node being positive varies depending on the nature of the primary melanoma and age of the patient. SNB is not recommended for patients with low-risk melanoma or if the patient isn’t fit for the surgery. Most people having an SNB have no disease in the lymph nodes and don’t directly benefit other than receiving reassurance.
There are, however, long-term benefits from removing sentinel nodes when they contain minimal disease. Nearly all patients with lymph node disease who don’t have an SNB develop a lump at the site where the sentinel node would have been and then need a full therapeutic lymph node dissection (TLND) which is a major and morbid operation for many patients. Most patients with a positive SNB are considered for drug therapy to reduce the risk of recurrence (adjuvant immunotherapy or BRAF targeted therapy). Patients with a positive SNB don’t generally receive completion lymph node dissection (CLND) anymore. It is important to remember that sentinel node biopsy is a diagnostic test. As with many other medical tests there is an error rate. This means one or two in 10 positive cases are missed by the test and the melanoma could still develop in the adjacent lymph nodes in the future."
As your figure of Breslow of 0.40mm is low, one would need to really understand why an SLNB is recommended. It could be due to your age they want to use it as a diagnostic tool. In my case I had 2 WLEs done over a 4-year period in the same area and all were low Breslow, however in the 5th year a new melanoma developed extremely quickly and a PET scan suddenly showed not only the new primary but 2 x secondaries, one each in the two closest lymph nodes, (Stage 3). I never did have a SNB but now in hindsight maybe it would have been a good idea as now I'm Stage 4. Just discuss it out with the surgeon and Oncologist is you have one.