Supraclavicular node

[Carys]

After further reading, it does appear that after 6 weeks they image anyway.......

Lymphadenopathy after COVID-19 vaccination can confuse physicians

Imaging should be performed prior to vaccination or postponed for at least 4–6 weeks after COVID-19 vaccination unless a patient has an urgent clinical indication.1 When imaging is required after vaccination, institutions should document COVID-19 vaccination information, including date(s) of vaccination(s), injection site(s) [left or right, arm or thigh], and type of vaccine in a patient questionnaire that is readily available to radiologists.1 ^, 4 Recognition of supraclavicular lymphadenopathy as a self-limiting immune reaction in the setting of recent ipsilateral arm vaccination against COVID-19 may reassure patients and avoid unnecessary aspiration or biopsy of lymph nodes. More conservative approaches, such as observation for at least 6 weeks until resolution or short-term follow-up with ultrasound to ensure resolution of lymph nodes, are recommended rather than immediate biopsy of the nodes in patients with axillary and/or supraclavicular lymphadenopathy after recent ipsilateral COVID-19 vaccination.

......I think your PCP could have been a bit more gentle and reassuring with you though, considering your background. There are certainly plenty of incidences of supraclavicular lymphadenopathy documented, as even people on here are talking about, so I hope you aren't worrying too much as he/she could really have been more supportive and given context.

[StephA]

....I get you Steph, and your fears here. Can I just ask, I presume the jabs were given in your non-BC surgery side ? It seems that you have some cause and effect going on here, it seems strange that it would be days after the first injection that your nodes came up - like the co-incidence would be surely very strange after so many years to get a new primary or recurrence (or metastatis) happening at the same time ?

I've done a quick medical journal search and it seems there are plenty of studies to support nodes (particularly axilliary types) being raised for a long time after vaccination. For example -



The 'having a history' is so troublesome at times, there is generally an over reactive-ness I have experienced myself. Its kind of 'good' in one way, but it also makes you incredibly nervous I know. I know my response won't have helped too much, but I was just wondering what you think you might decide to do, get another opinion ?

Hi Carys! Yes I get all my vaccines in my left arm since the cancer was in the right breast. I know you certainly understand my fear, being a breast cancer survivor yourself. I am thinking about going to an urgent care on Monday since my doctor doesn’t even want to examine me in her office. I know they’ll probably need to order an ultrasound, but I was mostly upset about her demeanor. This was a Zoom call and her body language just rubbed me the wrong way. She really didn’t want to hear what I had to say and she basically told me that no matter what the node felt like it’s most likely bad news, if it’s been swollen for over six weeks. Now I know I’ve read on here and other places that some people have had enlarged nodes for longer than that. I guess it’s the location of this one that has me nervous. But like you said the timing of it with the all the shots should make me less nervous. I know I should’ve stopped poking and prodding it but once I found it, I wouldn’t leave it alone and I messed with it several times a day. I don’t do it as often, but when I do, I still see how far I can push it around and feel it at least a couple of times a day. Oof! I know I am dumb to be doing that. You did help me with your replies and I truly appreciate it.

[StephA]

After further reading, it does appear that after 6 weeks they image anyway.......





......I think your PCP could have been a bit more gentle and reassuring with you though, considering your background. There are certainly plenty of incidences of supraclavicular lymphadenopathy documented, as even people on here are talking about, so I hope you aren't worrying too much as he/she could really have been more supportive and given context.

Thanks for all this info as well! She was not very supportive. I think eventually I’ll be seeking a new doctor. I don’t expect to be babied, but a little bedside manner goes a long way.
I hope all is well with you, Carys. Thanks again!

[Carys]

Yes, those doctors who understand the human mind and treat the 'whole' person, rather than just the body, are scarce it seems. It needs to be a 'partnership', with equal respect on both sides in order to work and certainly sounds like yours isn't going to work long-term. I actually found it quite interesting to read some medical papers on this node issue and vaccines, as obviously multiple vaccines over a year are not usual for a large percentage of the population - so there are certainly some interesting physical responses being thrown up in the process (the supraclavicular lymphadenopathy being one of them) . I don't know or understand 'Urgent care' (although it has been explained to me in the past) but would it now make a difference having someone feel them, as they will probably order the same diagnostic scans anyway, or would you be hoping that you encounter someone who can offer more a reasoned 'bedside manner' and alternative reassurance ? Im not a node checking person, but if I felt pain and as 'we' are trained to check those around the neck and shoulder after BC, then I can't say that I'd not be prodding a bit also, so don't feel too bad.

[StephA]

I’m hoping it’s just due to all the shots I’ve had in the arm. It’s usually just the flu jab I get, but that obviously changed when the covid shots came out. Urgent Care is just a walk-in clinic. I just thought going to one I could at least get a doctor to examine me. You’re right in the fact that maybe I should just let my doctor order the scan though. Then after that I could search for another family practitioner. I’m not a node checker normally. When my Oncologist feels for nodes he doesn’t dig deep. He just runs the pads of his fingers along the collar bone. I wish he was in Texas where I am instead of North Carolina. I don’t think it’s safe to fly due to covid. Planes are germ magnets as it is. Plus I don’t want to take a chance on flights being cancelled and be stuck in an airport. Ugh. Dang covid!

[StephA]

I have an appointment this morning with a nurse practitioner at the doctor my husband goes to. Didn’t sleep a wink last night. My collarbone is still sore when I move certain ways, lay a certain way or if the seatbelt hits it wrong, so that’s also worrying me a bit. I’m not sure if they’ll be able to tell me much today, but of course a physical exam will be the first thing they do, so I guess we’ll get that out of the way. Prayers are appreciated.

[kyllikki]

You got it, Steph. Let us know. Wishing you the best.

[StephA]

Thanks kyllikki!! The nurse practitioner felt it and said it didn’t feel hard or fixed. She said she felt one that was bad once in that area on someone and said she’d never forget how it looked and felt and said mine didn’t feel that way and it’s not sticking out. She said they have a sonographer that comes in on Friday’s, so I went back this afternoon for an ultrasound. The sonographer said she wasn’t seeing a lymph node. I assume she meant she didn’t see any that were concerning though. She said it looks like tissue and a ligament. Of course she still has to send it to a radiologist for analysis. Will have the results back Monday. I should be relieved but I’m still a bit anxious. Dang anxiety!