Lymph Node Status Lymph nodes are small glands that work as filters throughout your body. They contain immune cells that help fight infection and destroy germs carried in lymph fluid. There are hundreds of lymph nodes throughout your body and they are located primarily in the neck, armpits and groin. If the original, or primary, melanoma has certain high-risk characteristics, your doctor may want to examine your lymph nodes. This will help your doctor determine whether melanoma cells have traveled beyond the original site of the lesion. To check for this, your doctor will perform a sentinel lymph node biopsy. The sentinel node is the first lymph node to which cancer is most likely to spread. If melanoma is found, the surgeon may remove additional lymph nodes to check for melanoma. The extent of lymph node involvement, as well as other factors, will help your doctor determine your stage of diagnosis. It is very important to find out your stage as this information will help drive your treatment plan. If no melanoma is found in the lymph nodes, then it is likely that no additional surgery will be performed. Genetic Mutations in Melanoma Knowing your mutation status is critical for laying out your treatment options. Several genetic mutations are found in melanoma that “drive” the disease.
The BRAF mutation is the most common type of genetic mutation in cutaneous melanoma, appearing in approximately 50% of cases.
BRAF
The NRAS mutation is less common than the BRAF mutation but occurs in approximately 20% of cutaneous melanoma cases.
NRAS
The KIT mutation is the most common mutation in mucosal melanoma. This mutation is also common in acral melanoma.
KIT
GNAQ and GNA11
The GNAQ and GNA11 mutations are the most common mutations in ocular melanoma (melanoma of the eye).
Experts recommend that patients with high-risk Stage II and all Stage III and Stage IV melanoma patients have their tumors tested for genetic mutations. This will provide you with necessary information to make the best treatment decision for your situation. Read about therapies that target these mutations in the Stage III and IV sections of this brochure.
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