Enlarged Lymph Node in Armpit-Pet CT

[a_j]

I followed up to another Dr. She looked at my films and examined my breast. Said the mamo films looked fine and did not feel anything in my breast. She did say that on the sono, I have an enlarged right lymph. I can not even feel it? She said we can do 3 things here; wait and re-check it in a few months, or remove it completely and bio it, or do a PET scan. I opted for the PET, not knowing at the time that they shot radio active compound into you.



First, I ask myself why know one has done any blood work and two why did she not suggest a needle or core bio instead of complete removal?



Also, on these PET scans is it normal to to the full body CT or just an area where the node is? I'm not crazy about the idea of filling my body with this radio active dye.



Does anyone suggest I get a second opinion? I know Dr. are busy, but it just seemed like she was in a super hurry to move onto to the next patient and find another place for me to go?



This all started because I found a tiny pea-sized knot under my right armpit, small under the skin down below the armpit, located more off the lat. She didn't even feel that or look at it?



Help please!

[CCF-RN,MSN-rf]

Dear a_j:  In contrast to a breast mass, in general, when there is an enlarged lymph node that needs biopsy, an excision is recommended over a needle or core biopsy because these procedures may yield inadequate tissue to render a diagnosis.  Blood work is non diagnostic for breast cancer.  A PET scan is not considered a screening test.  When these are done, they usually include the full body.  If you are not comfortable with the opinion you have been given, you could contact this doctor to discuss your specific questions or obtain a second opinion.  Be sure to take your questions with you so that they are addressed.

[pattsy]

A_J, what do you mean by a pea sized knot.  What does it feel like.  I have a lump and not sure if fat, or lymph node.

[cyn17]

What about an ultra sound of the node instead of a PET scan? Is that possible for your situation? I've had ultra sounds of nodes in the past...very simple and non-invasive.

[a_j]

thank you for your replies.



They have done a sono on the node, actually it was the pea-sized little knot that I originally went in for. Thus they noticed the enlarged node in addition to the knot.



I'm just uncertain of the PET scan. I know it is to show if there are any positive nodes, but the radioactive dye concerns me.

[japdip]

I would NOT opt for a PET scan ... so many questionable results .... I would certainly see a surgeon about an excisional biopsy of the node in question. This should give you a diagnosis. The injection of radio-active material would be of little concern ..... you get that with other radiographic tests. It's the questionable results of the PET that would concern me .... could be that you would know nothing more after this very expensive test than you do now. Another opinion with a surgeon sounds like the place to start.   Best of Luck ......