New lymph node lesions

Nodes that have a short axis < 10 mm are considered non-pathological and should not be recorded. When a node increases in size so that the short axis is ≥10mm  then the criteria for being considered malignant have been met.  However, nodes that increase from for example 9mm to 11mm may not represent true disease progression, and we suggest that, providing that the change in the size of the node is the only evidence of progression, this be evaluated at the next response assessment, especially when the short axis node measurement is  < 15mm.  In the adjuvant setting, it is recommended that a suspicious node with minor size changes be biopsied prior to changing management.