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Forum Name: Breast Cancer

Question: Enlarged Lymph nodes


 jaykay515 - Sat Dec 10, 2005 12:36 am

I am a 76 year old female who had breast cancer 4 years ago.
I have an enlarged painless lymph node near my armpit.
An ultrasound was done and the radiologist then suggested a Pet Scan. My breast surgeon did a needle biopsy instead. I now have to wait for the results of my biopsy and I am very nervous. Beacue the lymph node is enlarged and painless and the radiologist asked for a pet scan does that mean there is cancer in the lymph node.
 Dr. Tamer Fouad - Sat Dec 10, 2005 1:38 am

User avatar Hello jaykay515,
It doesn't mean that you have cancer all it means is that they wish to exclude cancer, and by all available means.
Did the lymph node appear on the same side of the previous breast cancer or on the opposite side?
 jaykay515 - Sat Dec 10, 2005 2:36 pm

First let me thank you for taking the time to answer my questions it helps a great deal. It is a very nice service that you offer.
The enlarged Lymph Node is on the same side I had breast cancer. What scares me is that if you research information on the internet it says an enlarged lymph node is either from an infection which would cause pain or soreness ,and if it is painless and doesn't go away right away then it has to be cancer. There doesn't seem to be any other choices.
I don't know if it means anything but I have had rheumatoid arthritis for the past 40 years.
I had a biopsy on Tues and was suppose to get the results on Friday which they didn't have. The nurse said that usually if they find something serious they let the Surgeon know right away and that it is a good sign if the results from the biopsy take longer to get back. Does that matter?
 Dr. Tamer Fouad - Sat Dec 10, 2005 4:43 pm

User avatar jaykay515,
Thank you for your kind words.
I think it is a good sign and that the nurse's argument is credible.
Regarding pain/tenderness in an enlarged lymph node let me refer you to the only reliable population-based trial that was conducted to evaluate the clinical presentation and character and causes of unexplained lymph node enlargement.
In this Dutch trial it was found that pain in a lymph node can result when a lymph node rapidly increases in size, its capsule stretches and causes pain. Pain was usually the result of an inflammatory process or suppuration, but pain was also the result of hemorrhage into the necrotic center of a malignant node. The presence or absence of pain/tenderness was not found to be a reliable way to differentiate benign from malignant nodes.[1]
Please let me know when the results of your biopsy are out.
Best regards.

References:
==========
1. Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract 1988;27: 373-6.
 jaykay515 - Sat Dec 10, 2005 6:29 pm

Thank You Very much for all the information. It has been very helpful. I will let you know how things go. One more question the fact that i have an enlarge lymph node on the same side as my previous breast cancer,does that matter? And also is it possible that when they did a biopsy on one of my lymph nodes when i originally had breast cancer to see if it spread to the lymph nodes that this could cause swelling in that lymph node years later.
thanks again for all your help
 Dr. Tamer Fouad - Sat Dec 10, 2005 6:52 pm

User avatar Hello again,
Yes it is significant if its on the same side or not, it could carry a better outcome if thats the only thing involved should be a recurrence. However, lets not jump to conclusions.
What was the surgical procedure you underwent? Was this a conservative mastectomy + sintenel lymph node biopsy?
It is unlikely that a biopsy can have any effect on a lymph node years lately. Please do not assume that it is infact cancer, the final verdict is not out yet.
Best regards,
 jaykay515 - Sat Dec 10, 2005 7:16 pm

Sorry to ask so many questions. I am a little confused So is having the enlarged lymph node on the same side of where the breast cancer was four years ago a bad indicator or a good indicator ? Thanks
 Dr. Tamer Fouad - Sat Dec 10, 2005 7:38 pm

User avatar jaykay515,
We are really jumping ahead of things here. The presence of a lymph node enlargement on the same side as the breast cancer as opposed to its presence on the opposite side will not help us determine its likelyhood of being cancer vs. infection.
If however, it turns out that it is a cancerous lymph node and that this is the only location where the disease is present then this is a good sign because it means that the recurrence is localized and has not spread outside the initial location to a distant location (opposite side). Such cases where the cancer has spread distantly are considered metastatic (stage IV) disease.
Let's take it one step at a time. I understand your anxiety, but the only thing that can make you feel better now is hopefully the result of the biopsy. Any other information won't help at this stage.

Best regards,
 jaykay515 - Sat Dec 10, 2005 8:57 pm

You are right . The best thing is to wait for the results of the test. Thanks again for for taking the time to answer my questions. I will let you know how everything turns out. You are doing a great service for people who are concerned about their health.
 jaykay515 - Wed Dec 14, 2005 11:57 pm

I got my test reports back and everything came back negative. What a load off my mind. I want to thank you for all your help and the fact that you don't know me but showed you cared is a great quality . Keep up the great work we need people like you in this world.
 Dr. Tamer Fouad - Thu Dec 15, 2005 12:52 am

User avatar Thank you very much for your kind words, jaykay515.
I wish you all the very best, always.

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