There is probably no more controversial area of melanoma management than sentinel node biopsy. Patients are routinely offered this procedure as if it improves outcome; which it emphatically does not.
Marvin Kanzler has written an important essay on this topic. He writes" "Physicians who actually diagnose melanoma are in an ideal position to discuss these facts with their patients, because they are completely free of financial conflicts of interest (the Medicare reimbursement for the SNB procedure is approximately $19,0004). ‘‘Discussion’’ versus ‘‘recommendation’’ is an important distinction. The decision ultimately should be made by the patient. The physician’s role is to provide the unbiased information necessary for the patient to make this important decision."
Dr. Kanzler's article is important. We have placed this article on Google Docs for those who want "discussion" not a biased "recommendation."