Physical Exam

Axillary Lymph Node Palpation

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Video coming September 2026

How to Perform

With the patient seated, slightly abduct and support the arm of the axilla being examined so the muscles remain relaxed. Use the finger pads of your other gloved hand to reach as high as possible into the apex of the axilla. Press the finger pads against the tissues and palpate with small circular motions while gradually drawing the hand downward through the central axilla. Then repeat the maneuver with the finger pads directed toward the anterior wall for the pectoral nodes, the posterior wall for the subscapular nodes, and the lateral wall along the upper humerus for the lateral nodes. Repeat on the opposite side. Note the size, consistency, tenderness, and mobility of any palpable node.

How to Interpret

Breast Cancer

Node-positive Breast Cancer

Palpable axillary lymphadenopathy in a patient with known or suspected breast cancer

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

Infectious Mononucleosis

Axillary or inguinal lymphadenopathy in an adolescent or young adult

Rule in

Somewhat helpful

Rule out

Minimally helpful

Evidence:Limited

References

Cai X, Ebell MH, Haines L. Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis. J Am Board Fam Med. 2021 Nov-Dec;34(6):1141-1156. doi:10.3122/jabfm.2021.06.210217. PMID 34772769.
Sharma SK, Kadhiravan T, Banga A, et al. A clinical prediction rule to identify patients with tuberculosis at high risk for HIV co-infection. Indian J Med Res. 2009;130:51-57. PMID: 19700801
Majid S, Tengrup I, Manjer J. Clinical assessment of axillary lymph nodes and tumor size in breast cancer compared with histopathological examination: a population-based analysis of 2537 women. World J Surg. 2013;37(1):67-71. PMID: 22976793.
Chau I, Kelleher MT, Cunningham D, et al. Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients. Br J Cancer. 2003;88(3):354-361. PMID: 12569376.
Specht MC, Fey JV, Borgen PI, Cody HS 3rd. Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg. 2005;200(1):10-14. PMID: 15631914.
Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract. 1988;27(4):373-376. PMID: 3049914.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.