Mammographic and Clinical Correlation of Axillary Lymph Nodes

ABSTRACT

BACKGROUND: The purpose of this study was to determine the cause of the axillary abnormalities seen in mammography and to evaluate the imaging characteristics of benign lymphadenopathy and lymphadenopathy associated with malignancy. METHODS: One hundred ninety-three (193) abnormalities seen mammographically were retrospectively reviewed and correlated with clinical diagnoses and pathologic results found in the medical records of patients treated from August 1997 to July 1998 at the National Medical Center. For each abnormality, the length, the margins and the presence of microcalcifications were noted. RESULTS: One hundred seventy-eight (178) patients had benigh lymphadenopathy and twelve patients had metastatic breast cancer. The mean lengths of lymph nodes in benign lymphadenopathy & metastatic breast cancer were 13.7 mm and 22 mm, respectively (p=0.0002). Fatty infiltrations of benign lymphadenopathy were seen 157 patients (88.2%) while eleven patients with metastatic breast cancers had nonfatty infiltration and one patient had fatty infiltration. Among the patient with benign lymphadenopathy circumscribed margins were observed in 167 patients (93.8%), microlobulated margins in 7 patients (3.9%), and obscured margins in 4 patients (2.2%), while among the patients with metastatic breast cancer circumscribed margins were seen in 6 patients, obscured margins in 3 patients, spiculated margins in 2 patients, and a microlobulated margin in 1 patient. No microcalcifications were found in lymph nodes. CONCLUSIONS: For benign lymphadenopathy the size of the abnormality was less than 13.7 mm and it had circumscribed margin and fatty center. On the other hand; homogenously dense (nonfatty) axillary lymph nodes were strongly associated with malignancy when axillary lymph nodes were longer than 22 mm with ill-defined or spiculated margins; therefore, a biopsy should be done to confirm malignancy in such cases.