Home Forums Melanoma: Newly Diagnosed – Stages I & II Accuracy of SNB after WLE

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  • #20794
    TJNDND
    Participant

    Hi,

    I’ve been reading some conflicting information regarding Sentinel Node Biopsies being performed after the WLE and just wanted to see if I could get any information here. My wife was pregnant when diagnosed, and the doctors involved agreed that it would be too risky to perform the SNB at the time of the WLE because of the radioactive dye used. They have performed the WLE, and now are planning to do the SNB in 3 weeks, after the baby is born.

    I’ve been reading that the lymphatic pathways can be disrupted during a WLE, and that now it will be harder to find the sentinel node as a result. Basically, they will be able to find “A” sentinel node, but that it might not be “THE” sentinel node that would have been the outlet of drainage from the lesion initially. The doctor said that they would probably take out the identified sentinel node, plus a few from the surrounding area.

    My wife’s pathology report was 1.1. breslow depth, mitosis = none identified, no regression, clarks level IV, no ulceration, spitzoid type, margins unaffected, and clear margins after the WLE. Is the surgeon doing enough under the circumstances or should we be getting a 2nd opinion??? Thanks in advance!

    #57753
    Catherine Poole
    Keymaster

    Waiting until your wife gives birth should not be an issue. We had another patient here with the same issue. Remember that the SLNB is not a treatment buy a diagnostic tool. So making sure the baby avoids the radioactive dye is a good thing. There shouldn’t be any disruption in therapy if it is done this way. Hope all goes smoothly for the delivery!

    #57754
    cohanja
    Participant

    Catherine, you don’t think or there is no evidence that doing the SLNB after the WLE is disrupted by the WLE? Wouldn’t the lymph vessels leading from the lesion to the nearest lymph nodes be completed changed by the WLE?

    #57755
    Catherine Poole
    Keymaster

    No, plenty of folks have had their SLNB long after the WLE. There isn’t widespread evidence of issues. And you have to weigh the odds of this against the potential damage to the child. Our expert discounted there was any particular timing for the SLNB after the WLE in a previous post. This is also a fairly low risk depth lesion as well.

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