Topic: Biopsy of enlarged lymph node

Aug 14, 2010 05:04 AM debbie6122 wrote:

Mdoats, Hello, sorry you are having to deal with this, the waiting is the hard part, there are many reasons why a lymph node is enlarged, it dosnt always mean cancer, but since you had a suspicious area its good your dr, is doing a biopsy, is it possible to get another dr and have the biopsy so you dont have such a long wait? Even IF it is BC the waiting will be fine im just saying for your own peace of mind maybe you can get it done elsewhere.

80% if tumors are benign which is a good thing so hopfully it is nothng, Yes, they do a needle biopsy, make sure that they give you somthing to calm your nerves on before they do it, i had it done twice and my dr gave me some zanex,(valium) on the morning of i took one and an hour before my appt. i took another, im a big chicken when it comes to needles and it was not bad at all,(i promise) but the zanex really helped alot,please keep us posted and if you have any more questions we will be here for you, im praying for b-9 results for you

Gentle hugsssssss

Debbie

Aug 14, 2010 05:05 AM debbie6122 wrote:

Mdoats, Hello, sorry you are having to deal with this, the waiting is the hard part, there are many reasons why a lymph node is enlarged, it dosnt always mean cancer, but since you had a suspicious area its good your dr, is doing a biopsy, is it possible to get another dr and have the biopsy so you dont have such a long wait? Even IF it is BC the waiting will be fine im just saying for your own peace of mind maybe you can get it done elsewhere.

80% if tumors are benign which is a good thing so hopfully it is nothng, Yes, they do a needle biopsy, make sure that they give you somthing to calm your nerves on before they do it, i had it done twice and my dr gave me some zanex,(valium) on the morning of i took one and an hour before my appt. i took another, im a big chicken when it comes to needles and it was not bad at all,(i promise) but the zanex really helped alot,please keep us posted and if you have any more questions we will be here for you, im praying for b-9 results for you

Gentle hugsssssss

Debbie

Aug 14, 2010 12:04 PM mdoats wrote:

>>is it possible to get another dr and have the biopsy so you dont have such a long wait?

Thanks for replying. I do have the option of having another doctor do the biopsy, but I decided to wait for this one. She's the one my PCP recommended and I have total faith in my PCP and her recommendations. On the off chance that it turns out that I need to have something more than just the biopsy done, this is the doctor I would want. So I figured it's probably better to start out with her.

Thanks for the tip about asking for Xanax. I will discuss it with her when I see her.

Aug 14, 2010 12:23 PM cbm wrote:

I hesitated before responding because my enlarged node did turn out to be malignant.  The adjacent breast tumor was hiding in a fibroadenoma.  The node had been larger than the adjacent nodes for years, but then suddenly doubled in size.  The node was in the tail of my breast and apparently was a sentinel node.  it was the only one that contained cancer cells.

They found an adjacent breast tumor in the ultrasound after much searching and pondering and prodding.  I had a core biopsy on the breast and needle biopsy on the node.  

This is, of course, just my story.  Remember, you find the women whose symptoms were "something" here, because the others went along a different path.  You are very likely going to hear that your node is benign.

Cathy 

Aug 14, 2010 12:50 PM mdoats wrote:

Cathy, I'm glad you decided to respond. I really don't mind hearing from folks who had negative results.

At this point, I'm mostly just curious about what is likely to happen. I've had two mammograms now and an ultrasound. I'm guessing that my appointment with the surgeon will just be a consultation, but that she will likely elect to schedule a biopsy. That's what my PCP thinks will happen. I'm also guessing that if they find nothing during the biopsy, it will be over and they'll just have me do a 6 month follow up mammogram. But if they do find something, are they likely to do another ultrasound to look for other abnormalities? Is that what happened with you? Did you have the core biopsy and needle biopsy at the same time?

 Thanks for any information you can share.

Aug 14, 2010 04:24 PM cbm wrote:

Hello, mdoats.  I had first a regular annual mammogram, then an ultrasound to try to get a better image of the node, and to see what, if anything it was related to in my breast.  The tech I happened to have for the ultrasound had about twenty years of experience and wasn't going to let me out of the room without finding the root problem.  A fibroadenoma had grown around a malignant tumor consisting of IDC, ILC, DCIS, and LCIS, but it was a relatively small tumor, smaller, in fact, than the node.  She stayed on the area for a long time and then flagged an area that she said was slightly different architecturally, but looked mostly like normal breast tissue.  They did a second mammogram with the area flagged in anticipation of a subsequent biopsy.  They told me I had to have a biopsy, like right away.  I had no gynecologist, as she had retired immediately after writing me the mammo script and telling me my vitamin d levels were dangerously low.  I had to get a physician friend to write the scrips for everything, and called her for help when they told me I needed to return right away for the biopsy.  

I had the core biopsy on my breast and the fine needle biopsy on the node two days later (you can get a whole lot done in Florida in the dead of summer, no waiting, no lines).  If I had it to do over, I'd have gone to a surgeon for both, but the radiologist did both, in the same appointment.  I'm not sure that node required an immediate biopsy, given that they could see what the breast was up to once they had started the core biopsy--the material extracted was not normal.  

So, I got my news from the radiologist and had to kind of find my own way after that.  I went to Moffitt first to seek a surgeon, but then switched course and found an oncologist whom I trust and who managed all of my care, treatment, and referrals to surgery after that.  I then had a PET scan, Bone scan, and MRI with contrast.  In the MRI they found what they thought was another hot spot, and I had another ultrasound but had already decided on a bilateral mx, so it ended there.  After surgery, it turned out that all that was there was a 2cm node, and a 1.6 cm tumor. stage 2a, Gr 2.

There are occult situations where a node is the first presentation and no cancer is found, but those are fairly rare.  A node that isn't related to breast cancer and appears in the axillary region can also be related to some kind of infection (I was hoping for cat scratch fever, myself).  I was told that happens more often than you think.  

I hope this helps; remember you can ask for copies of all your reports, your BIRADS score, narrative, everything, if you want it, which I did.  

Peace,

Cathy 

Aug 16, 2010 06:39 PM Bagira wrote:

I have several enlarged lymph node in armpit region of the breast, one of which I can actually feel. I had ultrasound first, and then was told that few nodes look very suspicious (especially the one that I was able to feel), as far as both size (the largest one was 2.5 cm) and structure (abonormal shape, abnormal cortical thickening, etc..), and I was rushed for biopsy the same day. I was given a BIRADS score of 4C. At that time I was 16 weeks pregnant, so I think that's why they did the biopsy the same day. The radiologist was very concerned, and I could tell she thought it was cancer. She never found any other areas of interest in my breast though.

The type of biopsy they did was core needle biopsy. They took 6 samples from two different lymph nodes. The pain wasn't bad at all, but part of it was due to me being in quite a shock, so I didn't really care about the pain, I just wanted to know if I had cancer. The recovery was fine afterwards as well, I was able to resume my normal activites the next day.

After 6 days of unbearable waiting I was told that the results were reactive lymphoid hyperplasia, so basically lymph nodes reacted to something, no cancer found. I was still sent to breast surgeon, who did exam, and send me for a blood test and chest X-Ray to rule out lymphoma. All the tests came back OK, so he just watched lymph nodes for enlargement for the remainder of my pregnancy He originally planned to take one of them out afterwards (excisional biopsy, which is the most accurate, even though core needle is pretty accurate too, 95% or so), but then he felt like they started reducing in size and he basically told me that I am fine.

I went for a 2nd opinion to gynecologist-oncologist, he repeated mammo and ultrasound, and since lymph nodes were stable, he told me to come back in 6 month. I just had another ultrasound couple months ago, and was told that lymph nodes are alittle smaller, but to come back again in 6 month.

I still worry (what if something got missed!), I had asked about removing the node, but doctor wants to wait til I am done breastfeeding (actually, he doesn't really think I need it, but he will do it if it makes me feel better).

I did a lot of reading about lymph nodes, and found out that by imaging alone (like ultrasound, MRI) you can't distinguish inflamed lymph node and malignant one. And yes, there are many reasons why lymph nodes can enlarge, and sometimes they don't go down to normal size after enlargement. Good luck to you, and its great that you have a positive outlook.

Aug 24, 2010 06:51 PM dimdame wrote:

Dear Mdoats:

I am an Occult Cancer lady.  I have had an MRI, Pet, Cat, BSGI scans, and no primary tumor was found.  I just was operated on and of all the nodes removed, only the Sentinel Node was positive for Cancer.  My second opinion after being told I need the breast and all the nodes removed under my arm, I found a surgeon who only took out the nodes that looked "funny". Since I only have one node involved and no primary tumor, I will not have to have Chemo. However, I will need radiation and estrogen suppressing pills.

My Tumor Board Second Opinion thinks that my immune system fought off the primary cancer. My Sentinel Node has shown up on the Mammogram for two years, and remained the same size. The Mammogram Lab felt the node was benign.  Finally it was biopsied and low and behold, Cancer.  So, not to alarm you, I would suggest a biopsy be done. When my other nodes were removed in my operation they were inflamed, but in hind-sight they may have been that way because of the biopsy, but on never knows.  All of them could have been cancerous.  I will keep my fingers crossed that if you are biopsied the node is just doing it's job and fighting off infection.

Aug 24, 2010 11:59 PM mdoats wrote:

dimdame,

Thanks for taking the time to reply. I'd never heard of occult cancer and I'm just learning about sentinel nodes. Thanks for sharing your story. I'm meeting the surgeon next Thursday and I do think it's likely she will want to do a biopsy. I'll post an update after I meet with her.

Aug 25, 2010 01:34 AM leaf wrote:

A co-worker had a lymph node biopsy, and it ended up being she had a fungal infection from working on her roses.

Aug 25, 2010 09:12 AM, edited Aug 25, 2010 09:13 AM by Leah_S

A perfect example of a reason to refrain from stopping to smell the roses....

Leah

P. S. mdoats - best of luck with the appt and the biopsy. Praying for B9.

Sep 2, 2010 09:18 PM mdoats wrote:

I saw the surgeon today. She said she's not overly concerned about it the lymph node, but thinks it's probably worth doing a fine needle aspiration just to be sure. Scheduled it for 9/23. It does feel like a long time to wait, but when you get your appointment in order of priority, it's a good thing to be on the low priority list. So I'm okay with waiting.

Sep 3, 2010 09:24 PM amlg1 wrote:

I would definitly do a FNA.I am not telling you to alarm you,but my story, last year,2 enlarged nodes presented on my mammo(that I get every year)nothing in my breast showed up,even being called back for more views.The FNA told the story,abnormal cells were present.The MRI,found the cancer in my breast.Now on the other hand my dad,many years ago had and felt large nodes in armpit,Dr.removed them,and it turned out to be nothing.So it is good you are being followed up witha FNA.Waiting 2 weeks will be fine.Good Luck!

Sep 23, 2010 06:48 PM mdoats wrote:

Had the FNA this afternoon. It wasn't bad at all. Another week until I get the results.

Sep 23, 2010 08:55 PM flopsy wrote:

mdoats,  Hoping for B9 results on your FNA.   Hugs, Ginny

Sep 30, 2010 06:42 PM mdoats wrote:

I've been posting in the "Waiting for results" forum, but thought I'd cross post my results here in case anyone was wondering.

Good news! The results of the FNA were consistent with intramammary lymph node. No evidence of metastatic carcinoma identified. 

The slightly less than great news was that "The scant material remaining in the cell block is not optimal for ancillary studies. Recommend clinical correlation and consideration of additional tissue sampling for flow cytometry if clinically indicated."

The doc said normally she would do another FNA to run the additional tests, but because I experienced cellulitis from the last FNA, she's reluctant to do another one. She said she could go in and remove the lymph node, but that she thought that might be a bit extreme given the other findings and the fact that the lymph node is 1.4 cm. (She would have recommended removal if it was 2 cm or larger.)

We discussed and I opted to do follow-up ultrasound in 3 months. In the meantime, the cellulitis is improving and I'll be going back next week so they can keep an eye on it.

So, while it's not a 100% clear, it's pretty darn good news!