Presentation
Screening mammogram; no significant complaint
Patient Data
Breast density: scattered areas of fibroglandular density (ACR B)
Both breast parenchyma are normal (BIRADS-1).
No definite suspicious mass.
No suspicious microcalcification.
No architectural distortion.
No skin thickening or nipple retraction.
Axillary tails:
Right axilla: normal
Left axilla: unilaterally enlarged bulky axillary lymph nodes.
Conclusion:
Unilateral left axillary lymphadenopathy in otherwise normal bilateral breast parenchyma. The patient was referred to the breast clinic for a clinical assessment and further workup.
Case Discussion
Numerous benign and malignant etiologies can give rise to unilateral axillary adenopathy.
Although the most common causes are inflammation or infection of the chest wall, breast, or arm, metastatic axillary lymphadenopathy due to malignancy must be ruled out, such as:
1. metastasis from breast malignancy (must be excluded by mammography, ultrasound, MRI or even guided LN biopsy)
2. metastasis from non-breast malignancies:
melanoma
primary malignancy in ipsilateral arm
3. lymphoma
4.Recent COVID 19 vaccination
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