breast mass with small axilla lumps

[heather898]

I am 37- went if for an exam because I had a palpable (small very hard) lump in my lower left armpit. During the exam the doctor found a lump in my left breast. I was sent for a mammogram and ultrasound. The mamo came back negative (dense breasts). The ultrasound of the breast mass came back birads 4 and a biopsy was recommended. The axilla lump came back as hypoechoic lesions (there are actually 2) each less than 1cm and follow up was recommended. I've gone to see a surgeon who recommened a biopsy of the breast mass but is not worried about the axilla lumps which he said were lymph nodes. I have chosen to do a follow up on the breast mass rather than biopsy (I'm afraid of seeding possible cancer), but I'm starting to worry. So, I have two questions: Why would they not be worried about solid lymph nodes on the same side as the breast mass? And-- my surgeon assured me that there is no possibility of seeding breast cancer through needle biopsy, but I've read numerous reports that say otherwise-- is it possible?

[BhumikaMD]

Hi,

Axillary lymph nodes can be picked up on ultrasound even in normal individuals; they could be enlarged in various conditions including waxing, shaving, using a deodorant, infection, inflammation, etc.

Let us know about your reports and also about how you are doing.

Post us if you have any doubts.

Hope this helps.

Regards.

[heather898]

yes, that is what I meant by "seeding". Glad I'm not the only neurotic person out there :-)
Guess I will have to risk it if I want to know. I'm still hoping that the lump will magically disappear before my next appointment with the surgeon.

[Drumma]

Funny you should mention "seeding of cancer".  I thought I was being a bit neurotic thinking if they opened up the nodule during biopsy, it could send cancer cells through the body. Is this what you are referring to?  It makes a lot of sense to me!  It was a question I held my tongue about.  What other way could they find out if this was a malignancy other than to aspirate it?  I think the words, may, almost, could, are chance-y words that cover the fact that the possibility is there and we have to decide on the risk.  It's a horrible decision to make when your gut tells you otherwise.

[Drumma]

Funny you should mention "seeding of cancer".  I thought I was being a bit neurotic thinking if they opened up the nodule during biopsy, it could send cancer cells through the body. Is this what you are referring to?  It makes a lot of sense to me!  It was a question I held my tongue about.  What other way could they find out if this was a malignancy other than to aspirate it?  I think the words, may, almost, could, are chance-y words that cover the fact that the possibility is there and we have to decide on the risk.  It's a horrible decision to make when your gut tells you otherwise.

[heather898]

thanks- that does help. What about the axilla lumps? Are small solid lesions in the lymph node normal?

[BhumikaMD]

Hi,

Needle biopsy or FNAC (fine needle aspiration cytology) is infact a very safe procedure and there are almost no chances of seeding of the cancer. In addition, it is done as an OPD procedure in most cases and is not painful too.

It is the usual plan of management to follow up any suspicious lesion especially a BIRAD  grade 4 or higher with a biopsy for a confirmed diagnosis and to rule out cancer.

You should reconsult with your doctor and go ahead with the needle aspiration procedure.

Let us know what your doctor advises.

Hope this helps.

Keep us posted.

Regards.