Topic: Lymph Nodes on Ultrasound

Forum: Not Diagnosed But Worried — For those who are experiencing symptoms or received concerning test results, but haven't been diagnosed with breast cancer.

Posted on: Nov 15, 2017 11:40AM

Posted on: Nov 15, 2017 11:40AM

djmammo wrote:

Many of you have experienced pain under the arms or felt "swollen" lymph nodes and have had reports that were just short of complete in describing them in my opinion.

The overall size of a lymph node is more often less important than their internal architecture in breast cancer. The key is the thickness of the cortex and the appearance of the fat that lives in the center of the lymph node. When cancer cells enter a node the collect in the cortex making it thick. The increased volume of the cortex enlarges the node and compresses the fat in the center. An abnormal lymph node can be small with a thick cortex and completely effaced fatty center. A normal lymph node can be very large but have a very thin cortex and nice plump fatty center. If the cortical thickness in not included in a report that indicates an enlarged node, I would ask them to revise the report.

The images below are US images and corresponding line drawings of the progression from normal node to abnormal node on ultrasound. (From "the bible" 'Breast Ultrasound' a text book by A. Thomas Stavros, MD, the world's foremost authority on the subject)

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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May 20, 2020 04:35PM MelCam78 wrote:

Thank you so much! I will look.

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Dec 30, 2020 05:40PM wen513 wrote:

Thank you for this info! Would lymphoma nodes also appear malignant or just enlarged? I’m dealing with an inflamed right axilla node, appeared benign on u/s, but am referred for a biopsy. Mammogram and u/s found no abnormalities in breasts. I was curious that if it’s ‘more than likely’ benign, could it be something else, like lymphoma.

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Feb 16, 2021 03:37PM jlt814 wrote:

@Wen513 I'm dealing with a similar situation- One palpable reactive lymph node that I felt and which led to a diagnostic mammo and ultrasound. Both came back clear thankfully, but I have to go back in 6-8 weeks and see if the lymph node ( I think there are actually 3 of them that were larger than they should be) return to normal size. I received a Birads 3 and it says "probably benign". I'd love to know the accuracy of a radiologist in predicting this based on an ultrasound alone.

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Feb 16, 2021 03:45PM melissadallas wrote:

The radiologist who used to post here said ultrasound is a great tool on lymph nodes and being able to see if they are just enlarged or abnormal. Birads 3 is estimated to have a less than 3% chance of being cancer

LCIS, extensive sclerosing adenosis, TAH/BSO & partial omentectomy for mucinous borderline ovarian tumor. Dx 5/20/2012, LCIS, Stage 0, 0/0 nodes

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