Aims and objectives
Axillary nodes occasionally may be detected on mediolateral oblique mammographic images and may present a diagnostic problem for the radiologist.
While the most common cause is inflammation,
infection or trauma of the breast,
thoracic wall or arm,
a significant proportion of cases are due to occult malignancy.
Because there has been little scientific research on mammographic axillary abnormalities,
the only standard teaching has been that benign and malignant lymph nodes cannot usually be distinguished from each other mammographically.
Our purpose was to evaluate the pathological...
Methods and materials
From January 2005 to December 2012 a total of 57 patients out of 185.
479 women (0.03%) from the Screening Program in Cantabria,
Spain,
were found to have suspicious axillary lymph nodes with an otherwise normal mammogram,that required an ultrasound evaluation and a fine needle aspiration (44 cases) and/or a core needle biopsy (20 cases).
All patients underwent ultrasound scanning of the axilla that was carried out with a lineal 7 -12 Mhz transducer (MyLab 70XV,
Esaote,
Biomedica,
Genoa,
Italy).
The normal axillary node appear...
Results
Histopathology and/or cytology of these 57 lymph nodes showed 11 malignant and 46 benign results.
Of the malignant results,
6 were non-Hodgkin lymphomas and 5 were metastases from breast carcinoma.
Of the 46 cases with a benign results,
2 were granulomatous lymphadenitis (one tuberculosis),
2 showed patterns of sinus histiocytosis ( Fig. 1 ),
1 was a siliconoma and the other 41 benign results showed benign reactive lymph node hyperplasia ( Table 1 ).
The largest category (71.9%) seen was nonspecific benign reactive lymphadenopathy; this...
Conclusion
The percutaneous image-guided core biopsy or fine needle aspiration increasingly becomes an alternative to a surgical biopsy for the histologic assessment of breastlesions and lymph nodes.
Especially,
the ultrasound-guided procedure is safe,
fast and accurate.
Other advantages include its lack of ionizing radiation and the accessibility of all areas of the breast when the lesion is sonographically evident.
For those reasons we consider that patients with suspicious axillary lymph nodes and a normal screening mammogram require further evaluation with ultrasound and fine needle aspiration and/or...
References
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