Wisely choosing thin melanomas for sentinel lymph node biopsy

To the Editor: The routine use of sentinel lymph node (SLN) biopsy (SLNB) in the management of thin melanomas is controversial. For this reason, we read with great interest the article of Wat et al1 in which the authors examined 1072 cases of melanoma submitted to SLNB. Among these, 171 cases were thin melanomas and 15 of them (8.8%) showed SLNB positivity. Today, the scientific community is precisely focusing on the clinical significance of different histologic subtypes of thin melanoma. The current staging system for melanoma of the American Joint Committee on Cancer uses Breslow thickness as the primary attribute and up to 1-mm-thick melanoma is defined as "thin" because it shows good prognosis after surgical excision, with 10-year survival of 85% to 90% in case of tumor-free margin of at least 1 cm.

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