The port would ease the injection of 16 rounds of chemo. Just three weeks after my first mammogram, I was sent into surgery to have a port for chemotherapy implanted near my collarbone. It turned out I had a cousin in her late 40s who had recently gotten the same breast cancer diagnosis. Once we started talking about it, all kinds of family information came out. I didn’t know much about my family’s medical history, but an aunt on my dad’s side shared that his mother died of breast cancer in her late 30s. My genetic test returned with the result I dreaded: I was positive for BRCA 1, the hereditary mutation of a gene that is associated with breast and other kinds of cancer. This cannot be happening, I thought as my fiancé and I drove into my first appointment with the specialist. I had to tell my family, but I could barely get my head around it. I was diagnosed with stage 3 triple negative breast cancer. I told my boyfriend, now my fiancé, but nobody else in my family when I had the mammogram, then the ultrasound, then, the next day, the biopsy. “I am,” she told me, “because of the swollen lymph nodes.” I asked her: “Are you really concerned about that lump?” She was direct. I was too young to worry about lumps in my breasts. I was too young to have regular mammograms, so I didn’t know what to expect when my doctor advised me to get one. I was 37 years old and I’d just passed the LSAT and was looking forward to going to law school in the fall.I was healthy and active, had a great boyfriend, and my life was moving forward. Beneath my fingers sat a lump the size of an almond. Then she said, “Give me your hand.” She put my hand over hers and then removed her hand. We were chatting away during my breast exam when I felt her hand stop. She gave me another full physical, my second in six months. My doctor agreed it was a little strange that my lymph nodes were still swollen. ![]() I took my health seriously in any case: I work as a personal trainer. I’d had my full annual physical in January, and I was in great health - or so I thought. After three months I thought, “Hmmm.” My mind didn’t immediately go to a dark place or anything, but I thought it would be a good idea to have my doctor check this out. But several more weeks passed, and they remained swollen. I was told the nodes could remain swollen for six to eight weeks in reaction to the shot, and they did. I thought, “Great! The vaccine is activating my immune system. ![]() Right on cue, that’s how my body reacted to the vaccine. The lymph nodes under my arm have always served as the alarm bells when I’m about to get sick or am fighting something off. I’d heard people say they were tired afterward or their arm hurt, but I guessed which side effects I’d get: swollen lymph nodes. Everyone’s immune system is different, so the list of side effects was long. They are categorized a station 1 nodes International Association for the Study of Lung Cancer (IASLC) in the classification of thoracic lymph node stations.When I got my Covid-19 vaccine, I was told I might have side effects after the shot. Troisier sign is the name given to left-sided supraclavicular lymphadenopathy, highly suggestive of abdominal malignancy. Some malignancies such as lung, head and neck, breast, esophageal, gastric, pancreatic, gynecologic, and prostate cancers have a propensity to metastasize to supraclavicular lymph nodes. It is adjacent to the junction where incoming lymph is introduced back into the venous circulation through the left subclavian vein. ![]() One of the left supraclavicular lymph nodes, known as the Virchow node, drains the thoracic duct, abdomen, and thorax. Specific to the right supraclavicular lymph node is the drainage of the mid-section of the chest, esophagus and lungs. They oversee the transport of lymph from the thoracic cavity and abdomen. It is the final common pathway of the lymphatic system as it joins the central venous system. The supraclavicular lymph nodes (often shortened to the supraclavicular nodes) are a paired group of lymph nodes located on each side in the hollow superior to the clavicle, close to the sternoclavicular joint.
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