axillary lymph nodes

[sweetgrl]

I have nonpalpable enlarged left axillary lymph nodes - the largest measures 3cm.  I had a fine needle aspiration which was negative but my doctor still wants them surgically removed.  Is this necessary to have surgery given that the biopsy was negative?

[japdip]

Your Physician is correct in recommending the remmoval of the nodes. They can be tested more accurately at that time .... the type of biopsy you mentioned obtains such a small sample that it isn't really the best choice under these circumstances. It would definitely be to your advantage to have the nodes removed for better investigation. Regards .....

[Fernando Roque, MD]

Hi.  Any persistently enlarged axillary node which is more than 1 cm in size should be investigated further for the possibility of malignancy.  This means doing a biopsy of the node.  Fine needle aspiration biopsy (FNAB) is in my opinion, a poor choice of initial procedure in this case.  With FNAB, only a very small sample of the node can be taken by the needle.  It often happens that cancer cells in a lymph node are concentrated in just one area of the node, and not spread throughout the entire node.  So there is a possibility that the biopsy needle in FNAB won't be able to hit the cancerous area in the node and yield false negative results.  This is why it's better to do an excision biopsy in which the entire node is removed for examination, so that no area will be missed.  This is what your doctor is proposing should be done next.