Clinical importance of unilaterally enlarging lymph nodes on otherwise normal mammograms.
OBJECTIVE
To determine the clinical importance of unilateral enlargement of axillary or intramammary lymph nodes on otherwise normal mammograms.


METHODS
Twenty-four patients (aged 33-76 years) with unilaterally enlarging lymph nodes on otherwise normal mammograms were identified in a review of mammographic reports from 1991 to 1995. Mammograms, medical history, follow-up findings, and biopsy results were reviewed.


RESULTS
The initial nodal size was 3-17 mm. The size increased by 20%-312%. Seven patients had a history of malignancy. Six patients had a clinical history suggestive of a benign cause of nodal enlargement. Seven patients underwent biopsy. Two patients had results positive for malignancy (one, melanoma; one, lymphoma). Both patients had a known history of malignancy and a size increase of greater than 100%. In 17 patients, mammographic follow-up findings at 6-58 months (mean, 26 months) showed decreased nodal size in 13 and no change in four patients.


CONCLUSIONS
Enlarging lymph nodes on otherwise normal mammograms are usually benign. Clinical history can reveal possible causes of nodal enlargement. If the patient has no history of malignancy, the amount of nodal size increase is small, and the node maintains a benign appearance, mammographic follow-up is a reasonable alternative to biopsy.
Lee
C H
CH
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
Giurescu
M E
ME
Philpotts
L E
LE
Horvath
L J
LJ
Tocino
I
I
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008223:Lymphoma / Q000000981:diagnostic imaging; D008327:Mammography; D008545:Melanoma / Q000000981:diagnostic imaging; D008875:Middle Aged