Evolving Role of Sentinel Lymph Node Biopsy for Melanoma, Merkel Cell, and Squamous Cell Carcinoma.

Technical advances in lymphoscintigraphy, pathologic immunostaining, and intra-operative mapping in the setting of level 1 evidence have led to the adoption of sentinel lymph node biopsy as an accurate minimally invasive staging procedure. Currently, the procedure is recommended in select melanoma, all merkel cell carcinoma, and high-risk squamous cell carcinoma patients with clinically negative lymph nodes. In the future, ongoing discoveries in cutaneous oncology pathogenesis, systemic therapy, and predictive biomarkers research may allow for further data-driven evolution in the care of these patients to maximize survival and quality of life while minimizing morbidity of multimodal cancer therapy.