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Enlarged lymph node - left supraclavicular
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Enlarged lymph node - left supraclavicular

I am 35 year old female; over a year ago my pcp discovered an enlarged lymph node (approx 1cm+) in the left supraclavicular area and was very concerned.  no pain, etc - I didn't even know it was enlarged. The doc always checks lymph nodes during physical and had not been there before and I had had no type of infection over the prior year.  She was concerned, watched for a  few months and when it did not go away scheduled me immediately for a biopsy with a surgeon.  The surgeon checked, but thought it could possibly just be a shotty lymph node and requested a chest xray and mammogram - both which were ok.  Wanted to watch and have back  a few months later.  Next visit it was still there and he did not want to biopsy because the enlarged node is lying directly on top of a nerve/muscle that controls turning your neck etc.  Wanted to keep watching.  In the meantime, switched pcp's - new pcp checked, had another chest xray and he believes it could be a "calcified" lymph node.  Time goes by and the node is still enlarged (if increased, it is minimal) and am no further than I was over a year ago in determining what, if anything, might be the cause and if there should be any concern.  It is time again for yet another follow-up visit with the surgeon.  My question is, is there some other method of determining why/what this node enlargement is other than just monitoring or doing a chest xray.  Is there some other diagnostic tool or procedure that could be done to go ahead and determine if this is some kind of benign issue and put it to rest?  I really don't have any other issues going on (other than overweight, high bp & taking lexapro), however, several years ago I did have bladder polyps removed (cystitis glandularis w/ squamous metaplasia) and am monitored yearly for that and my mom has also been diagnosed with stage 3 invasive ductal carcinoma.  

Bottom line questions:  Should I be concerned; Should I seek second opinion surgeon; Is there some type diagnositic test/procedure that can be done aside from a full biopsy/node removal which could cause permanant damage? Or am I just being overly anxious?
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I agree with the work up thus far.

The only way to know for sure is via a biopsy.  Obtaining a second surgical opinion is recommended.  I would consider one at a major academic medical center if the location of the node precludes a straightforward removal.

Otherwise, I agree with the periodic mammogram and x-rays to exclude cancer in the breast and lung respectively.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
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