Enlarged Axilary Lymph Nodes

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PET Center Name
PET Center Address
PET Center Phone and Fax Number
Patient Name:
Policy Number:
Date of Service:
To Whom It May Concern:
(Insert Patient Name) is a patient of ours that was found to have an enlarged
lymph node in her left axilla on a mammogram performed in (Insert Date), the
rest of the mammogram was normal. She then had an ultrasound of her breasts
which only showed the enlarged lymph node. The ultrasound recommended a
biopsy.
The Biopsy was performed in (Insert Date) and was positive for malignant cells,
most consistent with adenocarcinoma. A breast primary would be most likely and
since her mammogram was negative her surgeon ordered an MRI of both
breasts which was also negative for any abnormalities in her breasts.
There are no specific NCCN guidelines to search for unknown primary cancers,
but imaging is the recommendation. Since her MRI and Mammogram were
negative the Oncologist ordered a PET/CT scan to search for a site of primary
tumor so a treatment plan could be developed.
PET/CT being a whole body image is the most sensitive tool to search for
unknown primary cancer. In order for treatment options to be determined a
primary tumor and extent of disease is crucial. The PET/CT showed no other
areas of disease therefore her treatment was TAC Chemotherapy for left axillary
carcinoma, this was based on her imaging results. She is ER positive for breast
CA based on lab results and will be restaged post chemotherapy and proceed
with surgical excision and possible radiation therapy.
Thank you for your consideration in this matter
Sincerely,
.
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