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Pain In The Armpits And Breasts. Mammogram And CT Scan Normal. Ultrasound Showing Node In Right Axillary. Had UTI And Respiratory Infection. Why This Was Not Detected In CT Scan?

Posted on Sat, 30 Jun 2012

Question: Hi I have pain I'm both armpits and breasts. Mammo ok ultrasound showed 3cm node in right axillary and ct of chest and abdomen without contrast was ok. Surgeon did not feel anything on exam nor did gyn. They said ct would show the large node and ultrasound that was done the same day as ct was wrong. Still have pain in underarms and breasts. I had uti and respitory infection 7 weeks ago. Should I be ok with what they tell me?

Answered by Dr. Dr. Rakhi Tayal (17 minutes later)

Hello,

Thanks for posting your query.

Since your mammogram and CT (Computerized Tomography) without contrast did not detect any axillary swelling, the possibility of any serious pathology is significantly less.

Since ultrasound scan has detected a 3cm node in the right axillary region, such a small lymphadenopathy might have resulted from the respiratory infection you had 7 weeks ago. Such lymph nodes may take even up to 3 months after an infection to subside.

The mild pain in the armpits may be a post viral infection pain which is usually relieved after taking mild pain killers like acetaminophen.

I would advise you to go for an MRI (Magnetic Resonant Imaging) scan of the chest to detect minor soft tissue or lymph node swellings. It is more sensitive as compared to CT scan in detecting such swellings.

Hope this answers your query. I will be glad to answer the follow up queries that you have.

Wishing you good health.

Regards.
Dr. Rakhi Tayal.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Rakhi Tayal (36 minutes later)

It all started with the uti and respitory infection but I also had rib pain in right upper quadrant. As I mentioned the ct of ab and chest showed nothing. Would a ct without contrast show a large node. The surgeon I saw after examining me showed me the ct and that it showed nothing. I still have pain down the sides of my underarms to the bra line area and intermittent sharp pains in breast. I had several blood tests and all ok except ldh was 209, 200 normal. The surgeon was not concerned with this.

Answered by Dr. Dr. Rakhi Tayal (9 hours later)

Hello.
Thanks for writing again.
A non contrast enhanced computerised tomography scan should detect a node 3cm in size.
A magnetic resonance imaging scam (MRI) will make you doubly sure regarding anything serious.
The pain may be a part of post viral syndrome. This will gradually subside. I would like to reassure you that in all probability, this is a temporary post viral syndrome and will subside gradually.
The likelihood of breast cancer is extremely low as a lesion would have definitely been picked up on mammography if the 3 cm axillary node was due to a malignant process.
The minor rise in LDH is not worrisome.
Hope you found this information helpful.
Regards.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Dr. Rakhi Tayal (3 hours later)

Hi one last question, you have been very helpful. Should I wait a bit to see if the pain subsides or ask for an MRI right away. Also can ultrasounds ever be misread as the surgeon thinks since my CT was done the same day and no node showed up? Also would a 3 cm node be able to be easily felt by a doctor, two doctors did not feel it on exam.

Answered by Dr. Dr. Rakhi Tayal (44 minutes later)

Hello.
You can wait for 2-3 weeks before asking for an MRI so that if the lymph node is due to an infective cause, it will subside by then.
Ultrasound can be misread as a large fat globule in the area will give the appearance similar to a lymph node.
A 3cm node if it is not very XXXXXXX can be palpated on an examination.
The finding of the ultrasound scan might be a mis-diagnosis also.
Please do not worry.
Take care.
Regards.

Above answer was peer-reviewed by : Dr. Yogesh D