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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Apr 8, 2019 03:55AM Kherps2 wrote:

i had a mammogram march 22 and it noted a change in lymph nodes on both breast from past mammograms and was sent for an ultrasound March 28 on my lymph nodes. Dr called Friday that I need a biopsy on a few nodes only on April 18 .I am scared and confused .

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Apr 8, 2019 07:01AM djmammo wrote:

Kherps2

Can you post both of those reports?


Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Apr 8, 2019 09:27AM Kherps2 wrote:

sorry at work how do I get the results ?

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Apr 8, 2019 10:17AM djmammo wrote:

Kherps2

Most facilities have a "patient portal" for reports and messaging. Call them and ask how to access it.

Board Certified Diagnostic Radiologist specializing in Breast Imaging. Contact me at DJMammo@gmail.com
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Apr 8, 2019 11:04AM Kherps2 wrote:

thanks

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Apr 8, 2019 11:27AM Kherps2 wrote:

It will take 24 hrs to set up my chart on line .Thanks for all you do .

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Apr 19, 2019 06:31PM bow1965 wrote:

Thanks for the information in this thread. I had my regular mammogram this week and was called back for a diagnostic mammo w/contrast and an ultrasound. I called my oncologist because of course I did (!) to find out what is up. I am almost exactly five years out from my original diagnosis and treatment, this finding is on my opposite side in the remaining breast. My oncologist said the report noted swelling of my axillary node and he was not concerned. He said the follow up was appropriate. He also said looking at the results that "you would have to prove to me that was cancer, I don't look at this and think 'prove to me it's not'" At any rate, how would one go about having a cancerous node without presentation of cancer in the breast? My understanding is elementary but I thought the flow was breast->nodes>elsewhere if it gets past the nodes.

I hate this scanxiety but I am VERY appreciative of this site.

Dx 3/2014, IDC, 3cm, Stage IIIA, Grade 2, 4/9 nodes, ER+/PR+, HER2- Surgery 4/23/2014 Lymph node removal; Lymph node removal (Left); Mastectomy; Mastectomy (Left) Chemotherapy 5/19/2014 AC + T (Taxol) Radiation Therapy 9/15/2014
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Apr 19, 2019 07:46PM marijen wrote:

It’s possible to have cancer in a lymph node. It’s called Primary Occult Breast Cancer. It means they can’t “find” the primary tumor. Why would your doctor expect you to prove anything, that’s his job. Can you get a copy of your report?

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Apr 19, 2019 08:20PM bow1965 wrote:

Oh, thank you marijen. I was having trouble finding information and it's good to have a name to search. My oncologist wasn't asking me to prove it, I didn't write that very well. His comment to me got lost in the translation of writing it down - he was saying when he looks at an image that sometimes he can immediately tell by the characteristics ie: prove to me that's not cancer. With my image he didn't feel that way at all and will look for my diagnostic tests on May 7. He was reassuring me that he didn't have any concerns. We have a long history with my breast cancer treatments and colon cancer in 2016 and I got what he meant even if I couldn't articulate here :)

I am very grateful for your response!

Dx 3/2014, IDC, 3cm, Stage IIIA, Grade 2, 4/9 nodes, ER+/PR+, HER2- Surgery 4/23/2014 Lymph node removal; Lymph node removal (Left); Mastectomy; Mastectomy (Left) Chemotherapy 5/19/2014 AC + T (Taxol) Radiation Therapy 9/15/2014
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Apr 19, 2019 08:29PM marijen wrote:

You’re welcome bow, I’m glad he is a nice doc. I only had one node positive. It takes a biopsy to know for sure but they can tell a lot from the US. Good luck. Oh and do you know how big the node is?

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