Large Axillary Lymph Node Overview
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The next finding as a potential
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recall from screening mammography
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is large axillary lymph nodes.
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And we, we always look at the axillary lymph
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nodes that are available to us on a screening
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mammogram and compare those to prior mammograms.
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And if they're increased from
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the prior mammogram or they're
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quite large on a baseline mammogram,
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we will recall that patient and will
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usually recall for an axillary ultrasound.
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There are lots of reasons for axillary adenopathy,
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including things like leukemia and lymphoma
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and breast cancer metastases, as well as mets
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from other primary malignancies, but then also
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infectious and inflammatory considerations like
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HIV, rheumatoid arthritis, other autoimmune
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diseases such as scleroderma, dermatomyositis
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and Sjogren's disease, some skin diseases
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like eczema and psoriasis, skin infections
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or inflammations such as rashes, poison ivy,
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cat scratch disease, hidradenitis suppurativa.
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Um, and then there's a large
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group of patients who may have had
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vaccination in recent weeks or months.
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And that includes.
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COVID-19 vaccine, influenza vaccine,
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Pneumovax, shingles vaccine, um, all of
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those can cause a pretty prominent immune
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response and enlargement of the lymph nodes.
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And the most recent one of these that
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we've really been seeing in sort of a mass
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vaccination campaign is the COVID-19 vaccine.
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So we've, you know, done a lot of work
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on this since we first started noticing
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large lymph nodes in January, 2021.
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And, um, you know, our guidelines and
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evaluation of this have evolved over
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time as we get more information about it.
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But all of those vaccines can
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make the lymph nodes large.
Lisa Ann Mullen, MD
Assistant Professor; Breast Imaging Fellowship Director
Johns Hopkins Medicine
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