Axillary Lymphadenopathy

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Isolated axillary adenopathy:
    • Is usually benign and resolves spontaneously
  • Persistent adenopathy of a malignant nature:
    • Is most commonly due to:
      • Lymphoma in men
      • In women:
        • Breast cancer predominates:
          • Followed by lymphoma and melanoma
  • Even so, the incidence of occult primary breast cancer with axillary metastases:
    • Comprises only 0.3 to 0.8% of all newly diagnosed breast carcinomas:
      • It is classified by the American Joint Commission on Cancer as:
        • CT0, cN1, cM0, stage 2A
  • When evaluating a woman with malignant adenopathy, the differential diagnosis must also include:
    • Lung
    • Ovary
    • Thyroid
    • Gastrointestinal tract
    • Liver
    • Pancreas
    • Kidney
  • Initial workup after a complete history and physical examination (including skin survey) should include:
    • A bilateral mammogram and an ultrasound:
      • If the mammogram and ultrasound are negative, a breast MRI is appropriate, followed by chest x-ray and CT scans if the MRI is unrevealing
  • References
    • Rueth NM, Black DM, Limmer AR, et al. Breast conservation in the setting of contemporary multimodality treatment provides excellent outcomes for patients with occult primary breast cancer. Ann Surg Oncol. 2015;22(1):90-95.
    • NCCN Guideline with NCCN Evidence Blocks™ – Breast Cancer Version 3.2019. National Comprehensive Cancer Network website. https://www.nccn.org/professionals/physician_gls/recently_updated.aspx. Accessed September 21, 2019
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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