Annals of surgical oncology
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A successful sentinel lymph node biopsy (SLNB) in melanoma patients requires an accurate map of the pattern of lymphatic drainage from the primary site. Lymphoscintigraphy (LS) can provide such a map. LS needs an understanding of lymphatic physiology, an appropriate small-particle radiocolloid, high-resolution collimators, and imaging protocols that detect all sentinel nodes (SNs). ⋯ Lymphatic drainage may involve SNs in multiple nodal fields, and drainage across the midline of the body is quite common. Because micrometastatic disease can be present in any SN regardless of its location, all true SNs must be biopsied. LS is an important first step to ensure this goal is achieved.