PURPOSE To determine if melanoma within the tumor microenvironment will result in immunosuppression within the draining lymph node as measured by down-regulation of T-cell receptor zeta (TCR zeta) expression. EXPERIMENTAL DESIGN Patients with clinical stage I to III melanoma undergoing wide local excision and sentinel lymph node biopsy or therapeutic lymph node dissection were consented to ha...

The procedure of sentinel lymph node biopsy in patients with malignant cutaneous melanoma has evolved from the notion that the tumor drains in a logical way through the lymphatic system, from the first to subsequent levels. As a consequence, the first lymph node encountered (the sentinel node) will most likely be the first affected by metastasis; therefore, a negative sentinel node makes it hig...

The worldwide incidence of malignant melanoma is increasing at an alarming rate. The importance of diagnosing nodal metastatic disease has impacted significantly on the accurate staging and stratification of melanoma patients. As a minimally invasive procedure with low morbidity, sentinel lymph node mapping allows for a detailed histopathologic evaluation involving multiple sections, H&E staini...

The use of sentinel lymph node biopsy for the T1 melanoma is controversial. Recent reports have demonstrated that certain T1 melanomas are at increased risk for early regional metastases and late recurrence when compared with all thin melanomas. The purpose of this study was to review the authors' experience with wide excision and sentinel lymph node biopsy for certain patients with T1 melanoma...

BACKGROUND The spread of mammographic screening programs has allowed an increasing amount of early breast cancer diagnosis. A modern approach to non-palpable breast lesions requires an accurate intraoperative localization, in order to achieve a complete surgical resection. In addiction, the assessment of lymph node status is mandatory as it represents a major prognostic factor in these patients...

En bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy has now been replaced by radical wide excision and selective inguinal lymphadenectomy based on the stage and location of invasive vulvar cancer. Early stage lateral cancers can be effectively treated by radical wide excision and ipsilateral superficial inguinal lymphadenectomy. Lymph node mapping using perilesional injecti...

Introduction: one of the foremost usual methods for evaluating breast cancer is the removal of axillary lymph nodes (ALN) which include complications such as edema, limited hand movements, and lymph accumulation. Although studies have shown that the sentinel gland condition represents the axillary nodules context in the mammary gland, the efficacy, and safety of the guard node biopsy need to be...

A. This guideline is written specifically for lymphoscintigraphy in patients with primary melanomas that originate in the skin. Staging of these tumors is based on tumor thickness (Breslow measurement) and level of skin invasion (Clark’s level), both of which are determined by the pathologist from a biopsy sample. Ample data correlate patient survival with Breslow and Clark measurements. In the...

Lymphatic mapping and sentinel lymphadenectomy is becoming an important surgical technique for assessing axillary status in breast cancer. In experienced hands, it can be successfully performed in >90% of cases. The morbidity of sentinel lymphadenectomy is minimal, considerably less than the 15%-20% rate of complications associated with axillary lymph node dissection. Moreover, excision of the ...

IMPORTANCE A practice gap exists in the surgical removal of sentinel lymph nodes, from removal of only the most radioactive (hottest) lymph node to removal of all lymph nodes with radioactivity greater than 10% of the hottest lymph node. OBJECTIVE To determine the clinical significance of melanoma in sentinel lymph nodes that are not the hottest sentinel node and to determine the risk for dis...