breast cancer following thyroid cancer?

[BeeBee300]

Hi Dr Lupo,

I had a total thyroidectomy and neck dissection in December last year for Papillary Thyroid Cancer that had spread to my lymph nodes. RAI in January 2010.  My last tests were all clear but I now have a large lymph node in front of my shoulder, well below the collar bone.  The supraclavicular nodes were all removed with the cancer in December and these nodes were clear.  The cancer was in the lymph nodes in Level 4 and 5.  Do you think this could be more cancer?

I didn't think we had lymph nodes in the front lower part of the shoulder. I thought they were in the breast or armpit area.  

What are the chances this is more cancer?  I am pretty worried as you can imagine.

Thank you Dr Lupo.

[BeeBee300]

Thank you Dr Lupo.  I appreciate your reply.

I believe this is an infraclavicular node and it is very large and 'rubbery' is the best description.  Not painful.  Do you think this could be thyca again?  My neck on both sides is hot and painful but I haven't had any illness or injury.  I'm terrified that this is cancer again.  

Best wishes.

[Mark Lupo, M.D.]

Your surgery in 12/09 included removal of nodes in the "lateral neck" - all the way to level 5.  This increases the risk of recurrent PTC in the lateral neck (would need to look closely with ultrasound including all neck levels (1-6)).  

Not sure what is meant by large node in front of shoulder below collar bone (in terms of anatomic location) - that could be axillary (arm-pit) or a lower level 4/5b node.  If you can feel it, it can be evaluated with ultrasound and possible FNA.

You mentioned breast cancer -- the treatment for thyroid cancer in 12/09 does not increase the risk, but there is some data suggesting that women with thyroid or breast cancer may be at increased risk for the other -- stay up to date with screening mammograms and breast exams.