Your doctor will look at the shape, color, thickness and size of any moles on your skin. If your doctor thinks it could be a melanoma, he or she may refer you to a special skin doctor, called a dermatologist.

If the dermatologist thinks that your mole might be a melanoma, you'll need to have an operation to remove some or all of it. (Your doctor may call this a biopsy.)

You'll probably be awake while the operation is done. You'll be given a shot to numb the area around the mole so you won't feel any pain.

During this operation your dermatologist may:

If the mole is very big or on your face, your dermatologist probably won't cut all of it out until you know for sure whether it is a melanoma. This is so you don't get a big scar on your skin unnecessarily. To find out more, see Surgery for melanomas.

You will have to go back to your doctor to find out the results of your lab tests. Your doctor will tell you one of three things.

Your doctor may talk about the stage of your melanoma. All cancers are classified according to how serious they are. This helps doctors decide what treatment is needed. Melanomas are classified according to how thick they are and whether they have spread. To find out more, see How melanomas are classified.

If cancer cells may have spread from your melanoma, your doctor will probably check your

 

 

 

 

 

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

 

 

 

 

 

lymph nodes for signs of cancer.

Lymph nodes are part of the lymphatic system, a network of vessels that is similar to your blood system. But instead of blood, your lymphatic system carries

 

 

 

 

 

lymph fluid
Lymph is a clear or whitish liquid that is collected from all over the body and flows through the lymphatic vessels and lymph nodes (also called glands). It contains proteins and fats, some red blood cells, and many white blood cells, especially lymphocytes. Lymphocytes help the body fight infection.

 

 

 

 

 

lymph fluid. The vessels of the lymphatic system pass through lymph nodes. Lymph nodes are small, round or oval lumps that you can't usually see or feel very easily. They are found in various parts of the body, such as the neck, groin and armpit. Cancer cells can get trapped in your lymph nodes and start growing there, or they can travel to other parts of your body.

Your doctor may feel the lymph nodes nearest to your melanoma to see if they are swollen or hard. If they are, your doctor may advise you to have surgery to remove them. They will be sent to a laboratory and checked for cancer.

If your lymph nodes seem normal, your doctor may not want to remove them right away. Instead you may be offered a test called a

 

 

 

 

 

sentinel node biopsy
Relatively new axillary staging procedure in which one axillary node (sometimes two or three nodes), called the sentinel node, is removed. The sentinel node is the first node to receive lymphatic flow from the breast, and it is detected by injection of a radioactive tracer into the primary tumor.

 

 

 

 

 

sentinel node biopsy. This test is used to find the lymph node that your melanoma would drain into (called the sentinel node). This node is then removed and tested for cancer cells. If there are no cancer cells in this node, then it's very unlikely that there will be cancer cells further away. If there are cancer cells in the node, your surgeon may suggest you have surgery to remove all the nodes in the area.

This is what happens when you have a sentinel node biopsy.

Sentinel node biopsy is still a fairly new way of checking lymph nodes. It lets the surgeon check if there is cancer in the area first, so nodes aren't removed unnecessarily.

Taking out the lymph nodes can cause certain side effects, such as infection and swelling. To learn more, see Side effects after surgery to remove your lymph nodes.

The results of a sentinel node biopsy can very occasionally be wrong. The test may very occasionally show that your lymph nodes are clear when if fact there are cancer cells in them.

 

 

 

 

 

Source:
Meirion Thomas J, Patocskai EJ.
The argument against sentinel node biopsy for malignant melanoma.
BMJ. 2000; 321: 3-4.

 

 

 

 

 

²

 

 

 

 

 

Source:
Jansen L, Nieweg OE, Peterse JL, et al.
Reliability of sentinel lymph node biopsy for staging melanoma.
British Journal of Surgery. 2000; 87: 484-489.

 

 

 

 

 

³ One study found that this is happening less and less often, because doctors are getting more experienced at doing sentinel node biopsies.

 

 

 

 

 

Source:
Morton DL, Cochran AJ, Thompson, JF, et al.
Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial.
Annals of Surgery. 2005; 242: 302-313.

 

 

 

 

 

⁴ In centers where surgeons do a lot of sentinel node biopsies, the test is very accurate.

 

 

 

 

 

Source:
Morton DL, Cochran AJ, Thompson, JF, et al.
Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial.
Annals of Surgery. 2005; 242: 302-313.

 

 

 

 

 

⁴

One thing that doctors still don't know is whether having a sentinel node biopsy is as safe as having traditional surgery to remove your lymph nodes. During traditional surgery, doctors remove all the lymph nodes in the area where you had cancer. Studies are being carried out to check if cancer is more likely to spread in people who have a sentinel node biopsy than in those who have traditional surgery to remove the lymph nodes.

 

 

 

 

 

Source:
Morton DL, Cochran AJ, Thompson, JF, et al.
Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial.
Annals of Surgery. 2005; 242: 302-313.

 

 

 

 

 

⁴

 

 

 

 

 

Source:
McMasters, KM.
The Sunbelt Melanoma Trial.
Annals of Surgical Oncology. 2001; 8: 41–43.

 

 

 

 

 

⁵

If your doctor finds cancer cells in your lymph nodes, you may need some more tests to see whether the cancer has spread to other parts of your body. (When cancer spreads, doctors say it has metastasized.)

Your doctor may:

 

 

 

 

 

Source:
Lang PG Jr.
Malignant melanoma.
Medical Clinics of North America. 1998; 82: 1325-1358.

 

 

 

 

 

¹

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