The technique of sentinel node biopsy

Fifty-five consecutive patients with localized melanoma and clinically definable regional nodal basin who had undergone sentinel node biopsy were reviewed. The technique described by Morton et al. was applied with the following modifications: (1) injection of a larger amount of isosulfan blue dye initially, i.e. 3 ml, on the side of the primary lesion facing the nodal group; (2) elevation of the primary site, for 5 min; (3) incision over the regional nodal group and exposure of the nodes with sharp dissection; (4) identification of either the blue-stained node(s) or adjacent colored lymphatics first and demonstration of their continuity. The sentinel node was identified in 51/55 (93%); specifically 33136 (92%) in the axilla, 17/18 (93%) in the groin, and 1/1 in the supraclavicular area. It was positive in 12/51 (24%). Mortonʹs technique of sentinel node biopsy is reproducible and can provide correct identification of the sentinel node in over 90% of the patients without the aid of radiolabelled materials.