This gap analysis identified significant underutilization of sentinel lymph node biopsy in early-stage melanoma patients who meet guideline criteria. The study characterized patient demographics and healthcare system factors associated with SLNB omission and highlighted opportunities to improve guideline adherence.

SLNB is underutilized in early-stage melanoma despite guideline recommendations, particularly among older patients and in non-academic settings.

Targeted educational initiatives may help close the gap between guideline recommendations and actual SLNB utilization rates.