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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31010
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I had a mammogram last October that showed a swollen lymph

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I had a mammogram last October that showed a swollen lymph node in my left underarm. Had ultrasound the same day that appeared to be fluid filled node. Repeat mammo in april still there. Yearly mammogram last week show still there. Breast is clear. Also a small swollen lymph node at base of skull on right side.
breast clear in all mammograms.
Also, when we sing at church....if we sing too many songs, or if I try to sing too loud, or something like that - my throat will start hurting and go sort of hoarse like. I also have more of an issue when I turn my throat to the side. If I turn while singing it gets worse. Also, if I swallow liquid with my head turned - it sends a sharp pain up my throat. I do not turn my head often and swallow. I guess I have trained myself over the years to keep straight without even thinking about it. But if someone hollars and I turn while drinking or something...then I notice it.
I have had swollen neck glands since I was a child. All these years, thought it was tonsils. I am hard under my ears and feel several swollen spots like lymph nodes from ears down neck. These have been there for a long time but episodes of issues of occuring more frequently.
I am now 43 years old.
Some occasional sinus drainage but nothing significant.
Can the two issues be related?
I thought about seeing a ENT.
Thanks for any advise or suggestions.
By the way, I work for a radiation oncologist. He does not think the underarm is cancerous or anything to worry with. I do not remember him mentioning much about the neck.
We did thyroid lab work several several several years ago. It was all normal. His PA at the time was very worried about my thyroid because the way it shows so clearly when I do certain things.
Submitted: 3 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 3 years ago.

Greetings Kelly.

The axillary lymph node and your throat / neck symptoms are unlikely to be related. As a matter of fact both of these are not anything worrisome or serious. All of us are worried about the small lymph nodes, if they are felt. But almost all the time they are non specific. Lymph nodes are our body's first defense. So they get enlarged due to trivial issues too like skin irritation, scratching, abrasions etc.

Pain during loud singing or turning during drinking or eating also is a non specific symptoms and do not particularly indicate a serious or significant issue. Since you work at a radiation oncologist and come across cancer patient; these kind of symptoms cause anxiety about the diagnosis of malignancy and can play in the mind. Thus for peace of mind you may get an MRI or a CT scan of the neck to categorically rule out anything abnormal. With your description, I do not think there is any significant pathological process going on.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


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Customer: replied 3 years ago.

The staff, including myself, always say we are over anxious with the word cancer being mentioned so often. I think we have diagnosed ourselves with every type of cancer at one time of another.


I am more concerned with the throat area than the underarm. I have heard of singers that had cyst or something in their throats. Not cancer. But that they would cause them problems and had to be removed. With some of them, the removal caused their voices to change.


When it happens while singing...

some times it just makes my voice weaker.

sometimes it causes pain that brings tears to my eyes and my voice completely goes away.

sometimes it is just like the sounds do not come out.


when it is mild - i can drink water and then be okay

when it gets to the point of hurting and that painful burn is in my throat I just have to stop singing.


sometime the swelling, especially under the ear, gets uncomfortable and sometimes painful. Like now. I would not say that I am in pain. But the ache is apparent. It does affect my hearing sometimes. Like can I explain it. It is like when you are driving up a mountain and your ears have that pressure build up and you move your jaws to clear them up. I am doing that but it is like you are still traveling. It does not clear it out.


You can clearly see and feel my thyroid. It does not seem to me that it is swollen as much as something else going on in the throat pushing it out.




Expert:  Dr. Arun Phophalia replied 3 years ago.
Hello Kelly,

All of your these symptoms;

1) some times it just makes voice weaker.

2) sometimes it causes pain that brings tears to eyes and voice completely goes away.

3) sometimes it is just like the sounds do not come out.

Would not indicate cancer, as you too mentioned. A cyst or laryngeal swelling or laryngitis may be a possibility. Reflux laryngitis also can cause this problem. Following investigations may be able to confirm it;


1) Barium esophagography

2) Ambulatory 24-hour pharyngoesophageal pH monitoring

3) Indirect laryngoscopy.


Following specialists are needed to work in tandem for treatment;


1) ENT specialist

2) Gastroenterologist,

3) Speech therapist,


Following measures are helpful:


1) Small 5-6 meals a day.

2) Last meal should be eaten 3 hours before lying down.

3) Avoid; fried or fatty foods, chocolate, peppermint, alcohol, coffee, carbonated beverages, citrus fruits or juices, tomato sauce, ketchup, mustard, vinegar.

4) Eat slowly so air is not swallowed.

5) Swallowing therapy by a speech-language pathologist.

6) Lose weight if obese or overweight.

7) Elevate the head of the bed by 6 inches.

8) Avoid tight clothing.

9) Stop smoking if you do.


An enlarged thyroid may also be responsible for it. Thyroid scan, an ultrasound and thyroid function test would rule out any abnormality.


The swelling near the ear can be a lymph node due to sinusitis which may cause ear issues. Parotid gland enlargement which is other possibility here is not likely for causative of these symptoms. Again a CT scan of neck will clearly diagnose any abnormality including this swelling.


It is privilege assisting you.

Customer: replied 3 years ago.

Thank you very much for your time and answers.

I believe seeing an ENT and having some test to clear up what is going on would be best.

I had rather know it is nothing big then to let Satan worry me with awful thoughts.

I too believe labs and CT's would be the best.


I was told many years ago that I had MS but it just had not shown up yet. I did not and do not claim that diagnosis. I have numbness. some noticed in hands and arms. Most noted in face. lips are almost always numb and face area too. Hard to explain but it is like I can feel skin surface and bone but the meat inbetween is numb. MRI's were done at the time and clear. The doctor I was seeing said fibro myalgia and underlying unconfirmed MS.


I believe going with all the above to a local ENT and having labs and CT should clear up all these crazy things.


I have lost weight but need to loose some more. But as a "chocoholic" and a southern girl - that is not nice to say give up chocolate, ketchup and fried foods. :-)


Thanks again for all of your help, advice and information.


I will move on to the next step.




Expert:  Dr. Arun Phophalia replied 3 years ago.
You are most welcome, Kelly.

May be slight anxiety too would be responsible for your symptoms. As we discussed, CT scan should be able to resolve the issue.

Good luck
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31010
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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