RE: Routine usage of sentinel node biopsy in melanoma management must cease

I read with interest the communication by Dixon and colleagues. I share concern if patients are being told therapies are only available to them if they have a sentinel node biopsy (SNB). SNB does more than offer a subset of patients added prognostic information. What the MLST-1 trial emphatically demonstrated is that SNB is a useful staging tool to stratify patients. Those with a positive SNB do significantly worse than those with a negative result. Furthermore, micro-metastases in a lymph node left alone, is highly likely to become macroscopic, prompting a therapeutic lymph node dissection (TLND).

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