TABLE 1.

Summary of NCCN recommendations for sentinel lymph node biopsy (SLNB) in patients with cutaneous melanoma7

Breslow depth <0.8mm without ulceration: <5% probability of positive SLN—SLNB generally not recommended unless microstaging uncertain

Stage IB, T1b melanoma Breslow depth <0.8mm with ulceration, 0.8–1mm with or without ulceration, or T1a <0.8mm with other adverse features (e.g., very high mitotic index ≥2/mm2, particularly in younger patients and/or lymphovascular invasion): 5–10% probability of positive SLN—discussing/considering SLNB with patient recommended

Stage IB (T2a) or II (>1mm thick, any feature, N0): >10% probability of positive SLN—discussing/offering SLNB with patient generally recommended (NCCN does note there are subsets of patients [e.g., non-mitogenic, older age] with “substantially lower” probability of positive SLN)