Axillary Lymph Nodes - Ultrasound Report

[percycute]

I am a 30 y/o female with one 9 year old child and no family history of cancer.  I went to my ob/gyn for an exam and mentioned being able to feel lymph nodes in both of my armpits.  I first noticed these lymph nodes almost a year ago, though didn't think anything of it, they could've easily been there for far longer.  I thought they might be from wearing very tight clothing & bras.  I also use silicone bra inserts because I am extremely small chested.  I weigh 100lbs at 5'5" (have always been very thin since I was a child) and have been able to easily feel lymph nodes come and go throughout my life.  

Should I be concerned about the lymph nodes, particularly in my left armpit?  Is a mammogram necessary?  I have been exposed to a lot of diagnostic radiation this past year (Chest, Abdominal, Foot, & numerous Dental Xrays - Conebeam Dental CT Scan - Radioactive Iodine Uptake Scan) and would like to avoid further irradiating myself, unless it is of urgency.  My breasts & chest appear to be clear on ultrasound & xray.  I have no pain or discharge, or changes in either of them.  The ob/gyn was unable to feel any abnormalities.  I have read that ultrasounds are more accurate at finding abnormalities in breasts of women my age, as opposed to mammograms.  Is this correct?  Thank you very much!

Bilateral Breast Ultrasound Report:
Ultrasound Findings:
Right Breast: Ultrasound imaging of the whole right breast was performed, selected images were submitted and labelled right axilla, right nipple, 12 o'clock, 6 o'clock, 9 o'clock, 3 o'clock, 11 o'clock, and 5 o'clock.  Ultrasound images of the right breast demonstrate normal fibrofatty and fibroglandular tissue.  No solid or cystic masses are identified.  No architectural distortion or skin thickening noted.  Images of the right axilla demonstrate 3 morphologically benign-appearing right axilla lymph nodes within cortices and fatty hilla.

Left Breast: Ultrasound imaging of the whole left breast was performed, selected images were submitted and labelled left axilla, left nipple, 12 o'clock, 6 o'clock, 9 o'clock, 3 o'clock, 11 o'clock, and 5 o'clock.  Ultrasound images of the left breast demonstrate normal fibrofatty and fibroglandular tissue.  No solid or cystic masses are identified.  No architectural distortion or skin thickening noted.  Images of the left axilla demonstrate 3 left axillary lymph nodes which demonstrate very subtle cortical thickening, but retain fatty hila.  Lymph nodes may be reactive and are not enlarged by size criteria.

Interpretation:
No suspicious sonographic abnormalities are identified.  Left axillary lymph nodes demonstrate very subtle cortical thickening which could be related to reactive inflammation.  Nodes are not enlarged by size criteria within either axilla.  No suspicious solid or cystic masses are seen in the breast on ultrasound exam.

Recommendation:
Additional bilateral diagnostic mammogram needed.

[japdip]

That's great news ... it is their "job" to enlarge under those circumstances and keep in mind that they do NOT always return to their normal size. They don't really "go away" they just shrink to a normal size (a small bean) as they are a very important part of our body. You made all the right moves; congratulations.   Regards ....

[percycute]

Well, 2 of the ones in my left armpit have gone away, there's only 1 left now.  I took some antibiotics, stopped shaving & using deodorant, also started using an anti-fungal soap.  The only ones that remain are the ones in my right armpit that looked normal on ultrasound.  So, since they're going down, I'm thinking/hoping it was some type of reactive inflammation/infection.  I'm guessing I may not need the mammogram now since the left armpit nodes were the reason for ordering it.  Hopefully, the others will go away, as well. :(  I'll still speak to my ob/gyn about it, of course!

[japdip]

You have posted a Negative report from your Ultrasound exam .... I'm not sure what you are seeking other than what is stated in the report. It states that nothing is found except the lymph nodes and lymph nodes alone DO NOT indicate cancer !! Lymph nodes become enlarged any time there is an infection somewhere in the body and they often do NOT go back to their normal size which is about the same as a bean. Being thin I would think you might be able to palpate nodes more easily and since you say they have been the same for at least a year or possibly longer I don't see anything to be concerned about. Mammograms are often not as useful in younger women due to the fact that the breast tissue can be rather dense and more difficult to "see through".  If you are still concerned then by all means go for the recommended Mammogram .... it might serve to ease your mind. You seem to be concerned about the amount of radiation you have received and of course you realize that the Mammogram will only be more radiation but I think it is completely up to you at this point.  Regards ..