, Volume 16, Issue 8, pp 2089-2091,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 12 Jun 2009

False-Negative Sentinel Node Biopsy

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The concept of the orderly progression of lymph node metastases is exciting and appeals to the surgical frame of mind. The momentum of the practice of lymphatic mapping may cause people to get carried away by their enthusiasm. It is thus important to keep an open eye for developments that may not live up to the expectations, and therefore, the paper from the Italian Melanoma Intergroup in this issue deserves attention. An important purpose of the study of 1313 patients with melanoma was to determine the ability of sentinel node biopsy to identify involved lymph node basins. The false-negative rate was found to be 14.4%; this high rate was obtained despite a meticulous technique and a comprehensive quality control program.1 High false-negative rates have been reported before but have rarely caused a stir.

For patients with melanoma, there has long been consensus on the principal aspects of the technique of lymphatic mapping. The combination of preoperative lymphoscintigraphy and intraope ...