Treatment Options for Stage I Melanoma
Treatment of Stage I melanoma is surgery and sometimes sentinel lymph node biopsy, based upon your stage of melanoma and your doctor’s assessment.
Surgery for Stage I Melanoma
To remove any cancer remaining after the biopsy. The procedure is called wide local excision.
The surgeon removes the rest of the tumor, including the biopsy site, as well as a surgical margin, (a surrounding area of normal-appearing skin), and the underlying subcutaneous tissue, to make certain the whole tumor has been removed.
The width of the margin taken depends upon the thickness of the primary tumor.
Most surgeons today follow the guidelines adopted and recommended by the National Institutes of Health and the World Health Organization Melanoma Program which call for a 1 cm margin in all directions. This typically results in a scar at least 6 cm (about 2 inches) in length, but it may be longer depending on the location on the skin and the size and orientation of the biopsy site. Skin grafting may sometimes be necessary to cover the wound especially on the face or on the fingers or toes.Read More about Surgery
Sentinel Lymph Node Biopsy (SLNB)
Sentinel lymph node biopsy is most accurate when the lymph channels around the primary melanoma have not been disturbed by a prior wide excision. Therefore, in general, the sentinel node biopsy and wide excision are done during the same surgery, with the sentinel node biopsy being done first.
Recommended for patients with:
- Stage I tumors equal to or greater than than 1.0 mm
- Ulcerated tumors of any thickness
- Positive biopsy margins
- Lymphovascular invasion (seeing cancer cells In the lymphatic channels or blood vessels
- Young adults with the presence of mitosis (rate at which cells divide)
- Determine whether any cancer cells have spread to the sentinel node, the first lymph node to receive drainage from the primary tumor, and the site where melanomas commonly spread to first.
- Further treatment will depend on whether the lymph node biopsy is positive.