Sentinel lymph node mapping in melanoma in the twenty-first century.

The incidence of melanoma is increasing faster than any other cancer. The status of the regional nodal basin remains the most important prognostic factor. Sentinel lymph node biopsy (SLNB) is recommended for staging in patients diagnosed with intermediate-thickness melanoma (1.01-4.0 mm). SLNB is considered somewhat controversial, especially when used to stage thin (1 mm), thick (>4 mm), or desmoplastic melanoma. This article reviews the current literature regarding SLNB in thin, intermediate, thick, and desmoplastic melanoma. Data supporting the use of newer radiopharmaceuticals in sentinel lymph node mapping along with newer imaging modalities are also reviewed.