Couldn't find sentinel lymph node--failure to map

I have heard of this happening but did not experience it myself. As I recall, a friend of a friend was the person to whom it happened and the oncologist wasn't terribly concerned. Someone else will have better information and I'll be curious to see the comments.

I was opposed to having a sentinel lymph node biopsy and only agreed to it the day before surgery. I am so glad that I had it now because, without those data points, my oncologists might have felt compelled to suggest very rigorous treatment in case the lymph nodes were already involved.

Clean lymph nodes and a very low OncotypeDX score helped me a lot in the decision process about treatment.

Thank you.

I had a bilateral mastectomy in April. Mapping of sentinel lymph nodes began first thing in the morning. The technician was wonderful. The first scan was 15 minutes after dye injection. She explained that it can be much slower, that they had a record of 3 hours. I beat that record and still just a possible "hint" on scans but nothing definitive. I was stressed and concerned as my surgery time arrived. Ultimately the hint was enough and a geiger counter used in surgery confirmed the location of the sentinel nodes.

I was in there for four hours and they never found the sentinel node in the right breast. The dr tried again right before surgery the next day and still didn't find it. I think it's very unusual, but he said it does happen sometimes.

This article addresses various approaches to identifying sentinel lymph nodes and the training issues so it must not be extremely rare. I wonder if there's some way of identifying the node even after surgery and doing a needle biopsy?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532881/

Thank you. One note at the end of the article says that failure to map is slightly more common in women over 65. I found more articles questioning whether sentinel node biopsy is necessary in women over 70 and maybe over 65. I'm 67. My doctor mentioned something about how in a year or two the thinking may shift away from sentinel node, at least for my age group.

My understanding is that a Sentinel Node Biopsy is used to find out if the cancer has spread into that first 'Sentinel ' node. They inject blue dye into the area and if they find it in the 'first' Sentinel Node, they know it has spread into the Lymph Glands, so they remove those. And if the blue dye doesn't appear in that first Node, you're clear of cancer in those glands. Now, I don't know where we are as regards 'mapping the breast area' because my scar for the Sentinel Node Biopsy is under my arm - not in my breast? The only scar I have on my breast is the surgical incision for my Lumpectomy.

I'll have to defer to others on that. I think the tech tries to see which node gets the dye first and then takes that node and tests it for cancer.

You may be right on that. I did more checking, but to be honest it was so technical in details it got confusing - to me at any rate. It talked about Subareolar, not into the tumor itself or the seroma cavity to follow after biopsy. At the Axillary hair border (which I had) to extend to the edge of the Pectora us major muscles (that last is where it got confusing). But it appears to be what I had. It's best really to have a chat with your doctor on the details.