Lumpectomy and Sentinel Node Biopsy

I had a stereotactic core biopsy that showed invasive, low grade, slow growing cancer.  A marker (or chip) was placed in the problem area to mark the spot for subsequent surgery.  Several days later,  a needle or wire or both were inseted as well as isotopes and a blue dye.  The lumpectomy and sentinel nodes showed no signs of cancer.  The marker was not found in the specimen. A follow up mammogram shows the specimen still in my breast.The surgeon is concerned that the marker moved.  I am now scheduled for follow up needle location and surgery.  How does the surgeon now know what tissue to remove to be sure he got the cancerous area?  There was no tumor that could be felt --my routine mammogram showed calcifications and an area of density. How often does it happen?  Are there aditional questions I need to ask my surgeon? or are these questions for the Radiologist?

Thank you so much.   Mary

[CCF-RN,MSN-rf]

Dear Sunlight: The only way a surgeon knows what to move is by the wire localization.  Unfortunately, tiny breast cancers may not look much different than normal tissue to the naked eye.  A mammogram may still show calcifications or density and the needle localization should target that area.  It is not uncommon for additional surgery to be required in the setting of lumpectomies, although it usually relates to positive margins (edges) on the pathology report.

[Sunlight]

Re my question on Lumpectomy & Sentinel Node Biopsy,  I note an error in my question--The tissue taken out at the time of Lumpectomy no sign of cancer and it did not have the chip or marker in the specimen either.  My concern is that if the marker moved, it may have moved away from the cancer and I do not understand how the surgeon will now know what to remove.  Thank you again.  It is so good to have a source for some of the answers that bother us after I think I got all the answers!

[surgeon]

the question is whether the spot that originally showed, and which was the subject of the stereotactic biopsy will still be visible on a mammogram. If so, it could be re-localized with a wire, ignoring the marker. On the other hand, if the marker wasn't in the specimen, it may be that it didn't move, and the wire placement was not exactly at the spot. The way to resolve it will be to re-image the breast before any more surgery is done. Possibly another stereotactic biopsy at the location of the marker would help, also