Description of Medical ServiceSentinel lymph node biopsy (SLNBx) is a procedure performed to determine if melanoma cells have spread to the sentinel lymph nodes for patients with intermediate thickness melanoma.
SLNBx with excision of lymph node(s) is identified by a combination of blue dye (lymphotropic dye injection) and lymphoscintography/gamma probe, ideally performed at the time of the primary melanoma wide excision.
Description of Medical ConditionMelanoma is a malignancy of skin pigment cells (melanocytes). The lifetime risk for melanoma in Australia is 1 in 24 for males and 1 in 35 for females. In 2011 there were 11,500 new cases diagnosed in Australia (Cancer Council Australia) and more than 1,500 die each year from the disease.
About 70% of cases are diagnosed at an early stage (<1.0mm thickness) where 5-year survival is > 95%. With increasing depth, there is a stepwise decline in survival. Sentinel node status is the most significant prognostic indicator in patients with intermediate thickness melanoma. Patients with intermediate thickness melanoma (1.0-4.0mm depth) have an increased risk of lymph node involvement and hence poorer survival.
Reason for ApplicationNew MBS item
Medical Service TypeInvestigative
Previous Application NumberNot Applicable
Application FormCompleted Application Form (PDF 698 KB)
Completed Application Form (Word 103 KB)
PICO ConfirmationDraft PICO Confirmation (Word 571 KB)
Draft PICO Confirmation (PDF 856 KB)
Public Summary DocumentPublic Summary Document (PDF 263 KB)
Public Summary Document (Word 100 KB)
Meetings for this Application
PASC11 August 2017
ESC8 June 2018
MSAC26-27 July 2018
Stakeholder MeetingWednesday 7 November 2018, members of MSAC, clinicians with experience and expertise in clinical oncology, pathology, dermatology and clinical genetics; representatives of the applicant; representatives from consumer organisations; and representatives from the Department of Health met to discuss sentinel lymph node biopsy for intermediate thickness and thick melanoma. This was not an MSAC decision forum, but a meeting that would inform the issues considered by MSAC, following its July 2018 consideration of application 1485. The final minutes of this meeting are below.
Final Stakeholder Meeting Minutes (PDF 374 KB)
Final Stakeholder Meeting Minutes (Word 57 KB)