Which finding after examining the midaxillary and supraclavicular nodes suggests malignancy?

Which finding after examining the midaxillary and supraclavicular nodes suggests malignancy?

• A. Nodes greater than 1 cm, firm, fixed or matted to underlying tissue
• B. Mobile, soft nodes
• C. Tender nodes
• D. Nodes that are freely movable

Answer: (A)

The key concept is that malignant lymph nodes tend to be enlarged, hard, and fixed to surrounding tissues rather than freely movable. In the midaxillary and supraclavicular areas, a node that is larger than about 1 cm, firm in texture, and adherent to underlying tissues or matted with other nodes raises concern for metastasis from nearby cancers (for example breast cancer with axillary spread, or abdominal/pelvic malignancies that reach the supraclavicular nodes). Having a node that is tender or soft and easily mobile generally points to benign causes like infection or reactive hyperplasia, where the node remains movable and not fixed to deeper structures. Freely movable nodes also tend to be benign. So the finding that best suggests malignancy is a node that is greater than 1 cm, firm, and fixed or matted to underlying tissue.

The key concept is that malignant lymph nodes tend to be enlarged, hard, and fixed to surrounding tissues rather than freely movable. In the midaxillary and supraclavicular areas, a node that is larger than about 1 cm, firm in texture, and adherent to underlying tissues or matted with other nodes raises concern for metastasis from nearby cancers (for example breast cancer with axillary spread, or abdominal/pelvic malignancies that reach the supraclavicular nodes).

Having a node that is tender or soft and easily mobile generally points to benign causes like infection or reactive hyperplasia, where the node remains movable and not fixed to deeper structures. Freely movable nodes also tend to be benign.

So the finding that best suggests malignancy is a node that is greater than 1 cm, firm, and fixed or matted to underlying tissue.