What is doctor supposed to do when sentinel lymph node biopsy fails?

@1cs,

Could you expand what you mean by sentinel lymph nodes biopsy fails? Did process fail to map where the sentinel nodes were? Are you saying it failed due to fact the nodes they took were negative? Or that they did not find the right nodes?

Did they do any node biopsy's prior to surgery?

Hi
Yes pls explain . If your sentinal nodes were negative that's good. Not sure what you mean by fail.

I received the biopsy shots at least an hour before surgery, probably longer, in a dimly lit hospital room.
I had stage 1 cancer in both breasts.
Left breast SLNB worked, and surgeon removed 2 good lymph nodes.
Right breast had tiny 4 cm stage 1 cancer and 7 good lymph nodes were removed. He said SLNB did not work. This was in a hospital setting.
He thought it was fine to remove 9 good lymph nodes. He had previously stated that he did not think that I had any bad lymph nodes, or he would not have recommended IORT to me. In all discussions only removing 1 lymph node on each breast was discussed.

Doctor said the sentinel lymph node biopsy did not work on 1 breast. I had 9 negative nodes removed. All discussions previous to surgery only mentioned testing 1 in each breast for a total of 2 to be removed.

Node biopsy was done sometime during surgery.

They would have injected you with a nuclear medicine that lights up with the gamma machine that they used to detect it and then they put the dye in at least mine was done that way my dye went in when I was out and he told me only the ones that light up they removed so I only had one and it was negative which is good

The doctor told me that zero lit up on the right side.

Hi
That's a good thing then no?

@1cs

Thanks for additional explanation.

The surgeon determines risk vs benefits of removing lymph nodes, how many do you remove to verify the cancer has not spread vs removing too many and causing side effects. On side that dye worked, he had benefit of dye to tell him which nodes in lymphatic system would be affected first. On other side he did not. So he had to be more aggressive. What is correct number is surgeon decision.

So, what is next? Definitely ask you surgeon or oncologist about affects of lymph nodes removal. I had stage 2 and after surgery had chemo and radiation. Then I had few appointments in lymphedema clinic. They measured both arms at each appointment, discussed things to do if have problems with swelling due to lymph node removal, etc. I was lucky, Stage 2 but only few cancerous lymph nodes. Had some cording (ask provider about) and no problems due to lymph node removal. Some patients have lymph system massages to help move fluid through. And there are exercise that help.

Ask provider for follow up appointment with a provider who can dissus / treat any concerns you have about possible lymphedema.

Now that your surgery is complete, do you have any additional treatments scheduled?

The right breast is the one that did not work. It was a tiny 4 mm. The man who administered the breast shots appeared to be at least in his 60's if not older. The shots were given in a dimly lit room an hour or 2 before surgery. I am questioning his ability to see properly in these conditions. Shouldn't the surgeon have shot the breast again or delayed surgery on the right breast, or at least used his skills to determine the sentinel node without the shot working? My husband & I had expressed our concern over the lymph nodes time and time again. All trends are for less and less lymph node removal. I had both breasts operated on at the same time. I already have lymphedema and have to go to clinic. I have a lot of side effects from having the underarm surgeries - hands, arms, and shoulders.
I don't get much sleep at all; and when I do then I wake up from my hands, arms and shoulders waking me up. My 4th and 5th fingers on both hands are the worst, I am right-handed. When I woke up from surgery, I was flinging both hands around and immediately noticed the numbness. I have had other surgeries and have never been treated this badly before. My husband was available with a phone call and was waiting in the hospital area. When I had knee surgery at another time and place, the doctor called my husband to let him know about some issues and discussed the plan to proceed with. Shouldn't this doctor have done the same? He knew that I would not have wished to have 9 good lymph nodes removed. Who in their right mind would? By the way, when 2 lit up on the other breast why couldn't or didn't, he figure out which ONE was the sentinel node?