Missing lymph node?

ready2bedone

I just got the call with my surgical path report. The good news is that the 3 sentinel nodes they took were negative. Also good was no cancer found in my right breast. However, what was puzzling is that in my core biopsy (and could clearly be seen in the ultrasound) there was a intramammary node that was involved that they couldn't find when they did my mastectomy! Has anyone had anything like this happen?

The path report says "the synoptic diagnosis incorporates findings from the current specimen and that of the prior biopsy. Specifically, the greatest extent of tumor reported here is based on the prior biopsy specimen (12 mm) which supersedes the maximal tumor extent in the current specimen (6 mm). Additionally, the current specimen shows no residual intramammary lymph node involved by metastatic mammary carcinoma; therefore the size of the metastatic tumor deposit is also based on the prior biopsy (2.1 mm)."

My BS thinks it might be possible that the core biopsy grabbed all of the lymph node, but who knows? I was on a hormone blocker for 2.5 weeks prior to surgery, but she doesn't think that was long enough to have shrunk the tumor and node. What's a challenge for them is how to stage this and what to do about treatment. She said after the first biopsy that I would probably not have chemo or radiation unless more lymph nodes were involved, esp if my Oncotype DX comes back low, but now she is saying she isn't sure. I am quite confused.

Has anyone had anything like this happen? A disappearing node or even the tumor size being quite smaller than expected? Thanks in advance.