title: Age and Breslow depth are associated with a positive sentinel lymph node in patients with cutaneous melanocytic tumors of uncertain malignant potential.
abstract: BACKGROUND
  Atypical melanocytic neoplasms present a therapeutic dilemma. Current consensus is to perform a sentinel lymph node (SLN) biopsy as part of management. However, it is unclear whether this is required in all patients. We present our experience with sentinel lymphadenectomy in these patients and examine the clinical and pathologic variables associated with a positive SLN.
  
  
  METHODS
  A prospectively maintained melanoma database was queried for patients with controversial melanocytic lesions. All patients between January 1997 and January 2009 were included. Demographic and pathologic information was collected and correlated with results of SLN biopsy.
  
  
  RESULTS
  Thirty-one patients underwent SLN biopsy. Median patient age was 19 years (range 5 to 59 years) and median tumor Breslow depth was 1.35 mm. Five patients (16%) had a positive SLN. Those with a positive SLN were younger (median 11 vs 23.5 years, p = 0.02) and had a greater Breslow depth (median 1.90 vs 1.09; p = 0.03) than those who were SLN negative. Median follow-up was 16 months for patients with at least 6 months of follow-up time and there have been no recurrences identified.
  
  
  CONCLUSIONS
  We report an SLN positive rate of 16% in patients with atypical melanocytic tumors. Younger age and greater Breslow depth are associated with having a positive SLN. These results confirm earlier work demonstrating the importance of SLN biopsy in this disease and highlight the need to measure Breslow depth in these lesions so that they can be appropriately stratified as to the need for SLN biopsy.
authors.affiliation: Department of Surgery, University of North Carolina School of Medicine at Chapel Hill, Chapel Hill, NC 27599-7213, USA. mmeyers@med.unc.edu
authors.forename: Michael O
authors.initials: MO
authors.lastname: Meyers
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Yeh
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.forename: Faera L
authors.initials: FL
authors.lastname: Byerly
authors.forename: John T
authors.initials: JT
authors.lastname: Woosley
authors.forename: Jill
authors.initials: J
authors.lastname: Frank
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Long
authors.forename: Keith D
authors.initials: KD
authors.lastname: Amos
authors.forename: David W
authors.initials: DW
authors.lastname: Ollila
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult