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All patients had a wide local excision of the lesion followed by a sentinel node biopsy.
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Assessment of nodal status currently requires surgery, by performing a sentinel node procedure, followed by an axillary dissection in case of a positive sentinel node [ 4].
Therefore, in order to reduce these complications by avoiding unnecessary Ax dissection, a sentinel node biopsy (SNB) or four-node biopsy has recently become popular.
Sensitivity for the detection of a positive sentinel node by ultrasound before a surgical procedure ranges between 39%and79%9%, and specificity is ∼100%.
Importantly, any method of reporting on the likelihood that a truly positive lymph node will be missed by the sentinel node procedure depends on the a priori likelihood that any lymph nodes are actually involved by melanoma.
Of the 24 patients enrolled, 14 patients (58%) had evidence of nodal positivity at baseline, either by pretreatment sentinel node procedure or FNA of a palpable lymph node.
A total of 25 patients (22.3%) had a positive sentinel node (proven by histology or immunhistochemistry), which led to primary or secondary complete axillary dissection.
We have previously reported a marked increase in the detection of metastases by using sentinel node techniques in colon cancer.
In 39 cases, USFNAC was guided by sentinel node lymphoscintigraphy using a hand-held gamma camera to locate the node.
Currently, axillary lymph node dissection is increasingly being replaced by the sentinel node procedure.
A technique which was supposed to increase the accuracy of US-guided aspiration is better selection of the node to aspirate by the sentinel node procedure.
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