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What Does A Positive Biopsy Result Of Enlarged Lymph Node Indicate?
Question: I received a positive result from a biopsy from enlarged lymph nodes in my left armpit....the result showed metastatic carcinoma most consistent with breast primary.
After an MRI on my breast, CT scans of my entire abdomen, PET scans of my entire abdomen, everything is normal...no breast , pancreatic, spleen, liver, kidney, etc. cancers. Now my oncologist is getting a second and third opinion from pathologists to check the DNA from the biopsy to see where the cancer is coming from. I have no symptoms. Can the DNA show where the cancer is coming from. Could the biopsy have a false positive? Could the biopsy have been read incorrectly?
After an MRI on my breast, CT scans of my entire abdomen, PET scans of my entire abdomen, everything is normal...no breast , pancreatic, spleen, liver, kidney, etc. cancers. Now my oncologist is getting a second and third opinion from pathologists to check the DNA from the biopsy to see where the cancer is coming from. I have no symptoms. Can the DNA show where the cancer is coming from. Could the biopsy have a false positive? Could the biopsy have been read incorrectly?
Brief Answer:
Sometimes no primary is found
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns. However, in around 5% of patients who just present with cancer in aermpit lymph glands, no primary is found, even after in-depth evaluation. These patients are mostly treated like a primary breast cancer.
Second opinion from pathologist is always welcome. We can do immunohistochemistry to find out the likely source. I understand that this is also inconclusive in your case. In this scenario probably they have recommended gene signtaure assay. Yes, this can help to give some idea regarding the primary but does not work always.
Lastly, we come to the possibility of incorrect biopsy report. This is not impossible but a pathologist takes utmost precautions before giving out a report of cancer. So second opinion is fine but I don't think it will come back as negative.
Hope I have answered your query. I will be available to answer further folowup queries, if any.
Sometimes no primary is found
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns. However, in around 5% of patients who just present with cancer in aermpit lymph glands, no primary is found, even after in-depth evaluation. These patients are mostly treated like a primary breast cancer.
Second opinion from pathologist is always welcome. We can do immunohistochemistry to find out the likely source. I understand that this is also inconclusive in your case. In this scenario probably they have recommended gene signtaure assay. Yes, this can help to give some idea regarding the primary but does not work always.
Lastly, we come to the possibility of incorrect biopsy report. This is not impossible but a pathologist takes utmost precautions before giving out a report of cancer. So second opinion is fine but I don't think it will come back as negative.
Hope I have answered your query. I will be available to answer further folowup queries, if any.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your informative reply Dr. XXXXXXX In my scenario mentioned above with no primary located in my body, would it be necessary to remove the left breast as well as the malignant lymph nodes in the armpit? And would you recommend chemotherapy and/or radiation?
Brief Answer:
Surgery should be done first
Detailed Answer:
Thanks for followup.
In this scenario, usually surgery is done first, commonly removal of entire breast and axillary nodes. After this, depending on final biopsy report, further chemo or radiotherapy is done. But the final pathology may also not reveal anything in the removed breast.
Other option will be to surgery in the glands with Radiotherapy to the breast. This is less preferred than the first.
Surgery should be done first
Detailed Answer:
Thanks for followup.
In this scenario, usually surgery is done first, commonly removal of entire breast and axillary nodes. After this, depending on final biopsy report, further chemo or radiotherapy is done. But the final pathology may also not reveal anything in the removed breast.
Other option will be to surgery in the glands with Radiotherapy to the breast. This is less preferred than the first.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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