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Introduction: Current melanoma staging guidelines consider all patients staged T1b to have the same metastatic risk and recommends that sentinel lymph node biopsy (SLNB) be considered in this disparate group. The goals of this study were to specifically determine predictors of sentinel lymph node positivity and those predictive for obtaining a SLNB in melanomas of Breslow thickness 0.8 mm to 1.0 mm, which has not been previously studied.
Methods: Retrospective review between January 1997 and July 2019 of patients with melanomas between 0.8 mm-1.0 mm in thickness. Patient demographics and primary tumor characteristics were correlated with SLN status.
Results: Of the 458 patients found to meet Breslow thickness criteria, 223 (61.8%) underwent SLNB. Multivariate analyses demonstrated that < 60 years of age (OR 2.42), increasing Breslow thickness (OR 1.27), mitotic rate >1 (OR 2.32) and presence of tumor infiltrating lymphocytes (OR 3.33), were associated with performing a SLNB. Positive SLNB was found in 20 (8.1 %). Univariate analyses revealed females (p=0.016) to have an increased risk for positive SLNB.
Limitations: Limited number of positive SLN and survival data available.
Conclusions: Younger age, Breslow thickness ≥0.9 mm, mitotic rate >1, and presence of tumor infiltrative lymphocytes were found to be factors predictive of performing SLNB. Female gender significantly increased the odds of a positive SLN.
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