Mammogram Call-Back: Rogue Lymph Nodes

Two years ago I had my very first “Why don’t you come back so we can take another look?” mammogram call-back, and in that case it was some microcalcifications, and they had me come back a third time and did a needle biopsy and said everything seemed fine. That was on the left side.

This year, another call-back, this time for “an asymmetrical area of density” on the right side. They said I would probably just have another mammogram to get some more views of that spot, but that if that wasn’t enough for the radiologist, they had scheduled me for an ultrasound right afterward, just in case. First I had the mammogram, and the technician warned me it would be “pinchier” than usual, because she was going to insert a little extra piece (about the size of a retainer case) to let her “really get up in there.” It was, yes, pinchier. She said “Sorry, sorry, breathe, sorry, sorry, hold your breath….okay, done, breathe!” for two images using the little retainer-case-sized prop, and then we did one more overall sideways view with no little prop.

She sent me back to the waiting room, and said to give the radiologist about ten minutes to look at the scans and then I’d probably be free. After about ten minutes, instead the ultrasound technician came to get me. She had me lie on my back with my right arm behind my head, and then twist my body somewhat to the left; it was more comfortable than it sounds. She spent much longer gliding the little paddle around than I’d expected; I wish I’d actually looked at a clock, since Medical Time can feel different than it is; but I was expecting, like, two minutes of paddle-gliding, and it was more like…eight? Long enough to start seeming awkwardly quiet and weird in the room, and for me to wonder how long it was SUPPOSED to take.

Then she said she would be right back, and when she returned she had the doctor with her. You should imagine Elizabeth Warren as a radiologist: that was her vibe. “Hello! Sorry!,” she said cheerfully/intensely. “I needed to see for myself!” The doctor took a turn gliding the little paddle around. She explained that there were some lymph nodes in the breast tissue, where she wouldn’t expect to see them, and that they were the mass she’d seen on the mammogram. She further explained that normal lymph nodes have a thinner outer portion, while scary lymph nodes have a thicker outer portion, and MYSTERY lymph nodes have a medium outer portion; mine are medium. The ones in my armpit are normal, but the ones in the breast, where she would not expect to see them, are medium: “plump.”

This made her want to solve the mystery, which is a drive I like to see in a doctor. She got real pointed about it, looking at them from many angles and saying to them “What are you DOING here? What do you WANT?” She asked if I’d had any sort of ANYTHING recently on my right side/arm: eczema? poison ivy? a vaccination? No/no/no.

She asked to check the other breast, saying if she found symmetry she would feel better. She did not find symmetry.

She thought aloud for a few minutes. She said “We could poke them with a needle? Take a sample? Well, but it’s not…. Or we could keep an eye on you, maybe have you come back in six months? But if…?” The technician and I, both aware we were not needed for this internal conversation, abided. The doctor wrapped it up and returned to us. She said, “Well. I can tell you it is NOT breast cancer. And of course when you hear lymph nodes you think lymphoma, but it would be very unusual, VERY UNUSUAL, to have lymphoma show up for the first time as a few rogue lymph nodes in the breast tissue, with the ones in the armpit completely normal! So I don’t know what is going on. My instinct, my INSTINCT, is to have you come back in six weeks and see what those lymph nodes are up to. We can always poke them with a needle THEN!”

And that sounded good to me, so I will go back in six weeks. I will be on Team Poke Them with a Needle, if given the option.

22 thoughts on “Mammogram Call-Back: Rogue Lymph Nodes

  1. Allison McCaskill

    Ugh, this kind of thing is icky even with the (very good, very wise) doctor being reassuring. I had a very similar – almost identical – ultrasound experience, and the question about the vaccination. I ended up having the biopsy, and the follow-up mammogram was normal, but they wanted me to have another ultrasound, except the place keeps not contacting me. So fun. It sounds like you’re cool and calm, but I hope the six weeks go quickly and the follow-up is uneventful.

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  2. Carol

    I have a “rogue” cyst/lymph node/SOMETHING very deep in my right arm pit; so deep it shows up on my mammogram every year. It even showed up on an x-ray/CT scan when I had frozen shoulder. FREAKS folks out when they see it for the first time. I had it biopsied several years ago and it was fine; we just keep an eye on it for any changes year over year. I will say the biopsy wasn’t fun, but it was a large needle and they had to go DEEP. I always say we’ve got lots of stuff floating around in us that’s not supposed to be there but isn’t really causing any issues until they do. Sounds like you’ve got a great doctor taking care of you!

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  3. Aimee

    I had unexplained lymph nodes in the past.
    I can’t tell you how much I wish I had your doc than the one I had at the time who declared I had Lymphoma and that they needed to do a biopsy to stage my cancer. Well then the biopsy showed nothing and the surgeon couldn’t even find the large lymph node he was supposed to biopsy. It was just a horrible many days that I really hope your doc’s thoughtful consideration will mean an entirely different experience for you.

    Reply
    1. Swistle Post author

      This is the sort of situation that makes me wish for FULL CONSEQUENCES (supernaturally-steered if necessary, as I’d assume WOULD be necessary for such a large and complicated system) for doctors—instead of what I assume happens now, which is that they say something like that to a patient and then go on to the next patient and never have any idea how wrong they were, or how bad they made someone feel for NO REASON, or how other doctors were MYSTIFIED by how wrong they were. Like, I wish that doctor to KNOW how wrong they were, and for them to also FEEL how you felt, and to USE THAT to GROW AS A PERSON. (I do not wish this for doctors who make genuine, honest, educated, HUMAN-NORMAL-LEVEL mistakes.)

      Reply
      1. Jd

        Counterpoint – Radiologists who do mammograms are one of the top specialties for medical malpractice lawsuits (radiologists as a whole are #3 or #4, mammography sue rates are double other imaging). This is a group of doctors who make huge judgement calls all day long and many are life or death. We sue them if they err incorrectly on the side of conservative (Dr says this area of density is symmetrical enough it is not cancer but later turns out it is). As a society we prefer the error of additional testing and medical anxiety over the risk of missing an issue. The side effect of this is that we will all experience extra testing and anxiety – I don’t think you want the inverse.
        Aimee’s issue could have been transient – a momentary inflammation that faded between image and biopsy. But at the moment of the image the doctor saw something serious. It may feel like a huge error because it made she extra anxious over nothing, but it could also be that 9 out of 10 radiologists would have said the same thing based on that snapshot and it’s not an error at all, just unfortunate timing.

        Also the radiologist likely got feedback from the referring physician.

        Save your anger for doctors who are rude and dismissive of people’s concerns, those who make actual errors that cause harm.

        Reply
        1. Swistle Post author

          Sure, but I’m not wishing (with, it should be noted, no actual effect) that the doctors will suffer PUNISHING LAWSUITS FOR INNOCENT MISTAKES, I’m wishing them to FEEL BAD FOR BIG ERRORS and subsequently GROW AS PEOPLE AND PROFESSIONALS. I’m going to continue to wish that (again: note that my wishes have no actual effect) on a doctor who declared cancer where there wasn’t any—which feels like too big an error to make casually to the patient, without getting more information first. If it’s so easy and understandable for a radiologist to see Obvious Cancer when there is no cancer at all, the radiologist should know that, too, and should order the additional testing without making the Scary Decisive (Wrong) Declarations, and I’m going to feel free to dole out some anger in that direction on behalf of a buddy who suffered. I have PLENTY left for doctors who err in the other direction: they are generously and easily included in my wish that doctors who make big errors should feel bad and grow as people.

          Reply
          1. Slim

            Considering how hard it is to get most doctors to even speculate before they have test results, Aimee’s doctor’s willingess to zoom straight to “It’s cancer” seems to call out for a special professional call out. So I’m glad that probably happened behind the scenes.

            Reply
  4. Berty K.

    I had a lymph node about the size of a golf ball under my arm and then my OBGYN also swore she felt a lump in my breast and then I went for a mammogram and all my lymph nodes were much larger than what they would call normal but not cancer large. We did follow ups once a quarter for a year and I lost 30 lbs from worry. It never turned into anything and I hope yours works out too.

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  5. ccr in MA

    I am sorry you’re in this worrying situation, but wow that doctor sounds like exactly what you want to have as you go through it! A really thoughtful doctor is such an amazing thing.

    Reply
  6. Nine

    I love your doctor. I love that she had to see things for herself and then talked it out with your plump lymph nodes.

    May your lymph nodes just be on a tiny vacation, Vacation Food included.

    Reply
  7. Mary

    I have to go in Thursday morning for a follow up for the very same thing. This used to happen every time, and I would fuss very hard about it, and then it would turn out to be nothing and all that quality fussing was wasted. So this time I’m doing something very abnormal for me and not fussing until I know there’s something to fuss about. Fingers crossed for both of us.

    Reply
  8. Suzanne

    This doctor sounds like the exact perfect kind of doctor for this situation. I hope the six weeks pass very quickly and that you have a lot of (happy) things to distract you during that time.

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  9. Joanne

    It’s so funny about tests and having them. My daughter did a study about virtual reality and the brain and she had to have an MRI as part of the study. It paid $150 which was a LOT for this 12 year old! Anyway, they called me a few months after to say that she had some WEIRD and CONCERNING things in her BRAIN which were shown on the MRI. I naturally flipped out and tried to make an appointment with the neurologist, who we already see because her brother has epilepsy. They couldn’t see her for SIX months, which made me think it wasn’t too big a deal but I was still freaked out so I asked my friend who is also a neurologist and she said people are walking around with this stuff all the time, and if she doesn’t have any symptoms, it probably isn’t anything. If she hadn’t had the MRI, you wouldn’t know anything! Sometimes I have to just give it over and leave it to the experts, and I’m glad you had that doctor look yesterday and be so reassuring. I hope the next six weeks fly by!

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  10. HereWeGoAJen

    My allergist is like this. She takes unexplained allergy things as a personal insult. She WILL figure it out and she WILL tell you what to do about it and then you WILL do it and you WILL get better. And she’s right, I am much better since she started figuring me out.

    Reply
  11. MCW

    Wishing you the best as you wait and hoping for the best news. I had a situation in which post-breast feeding, like for several years I could still express a drop of liquid from my nipples. Like if I were doing a breast exam in the shower, I’d give my nipple a squeeze and think, huh, there’s still a little liquid coming out. Then I heard a news story about someone who was diagnosed with cancer after finding discharge from her breast. So I asked my doctor about it. She recommended some extra imaging to check things out. We went around with a radiologist who thought there was something so keep an eye on and then a breast cancer doctor who took a look and gave the all clear. (In my case, the breast cancer doctor explained that the ducts and connections have purposes outside of breast feeding and can indeed have small amount of fluid in them. That was normal for me). All that was to say, I had a lot of gratitude that I could investigate this oddity with medical professionals. Your doctor sounds like a gem.

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  12. Sharon

    I’m sorry for the worry and the situation but MAN I’d love a get-to-the-bottom-of-it Elizabeth-Warren-vibes doctor! She sounds amazing. I hope the 6 weeks pass smoothly and the result of the next scan is an easy all clear.

    Reply
  13. Brittany

    Your doctor sounds amazing and like a perfect fit for you – so glad about this! And I love her 6-week follow up plan. I would be very on board, as well as your leaning toward the poke them with a needle strategy if they still seem mysterious in 6 weeks.

    Still sorry you need to go through this, but it sounds more mysterious than horrible pending news and like you have a great doctor and plan.

    Reply
  14. Saratoo

    To preface this, I’m 61 now.
    My mammograms have always led to a “call back” for further digital mammogram and/or ultrasound. And after the ultrasound “here’s the tissues for your tears, and everything is fine.”
    The second one, they called me while I was at my work Holiday lunch in the week before Christmas. The redo and ultrasound was in the second week of January. So I spent the holidays freaking out.
    Second week of January I drove 80km (50 miles) to the hospital with the digital mammogram and ultrasound. And waited for the radiologist to come tell me what she saw. The nurse came in with a box of kleenex.

    Everything was ok.
    The nurse brought kleenex no matter what as ‘everyone cries’.
    I’m about done with mammograms.

    Reply

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