Current New Zealand cutaneous melanoma management guidelines 1 note thin melanomas (<1 mm) can usually be cured by primary tumour removal, and while unnecessary in most cases, sentinel node biopsy (SNB) may be considered for patients with poor prognostic factors, such as ulceration or dermal mitoses (T1b 2 ). For patients with intermediate thickness melanomas (1–4 mm: T2 and T3), it is suggested SNB is useful for identifying small nodal metastases, allowing more accurate staging, better prognostication and improved regional tumour control. For thick melanomas (>4 mm: T4), from which haematogenous metastasis is thought more likely, it comments there is little evidence about SNB's role, but the procedure may be considered in select cases. With this background, it is recommended patients with T1b or higher cutaneous melanomas should be referred to a surgical specialist for consideration of SNB at the time the initial biopsy site is re-excised with wide margins determined by Breslow thickness.