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Keywords:
Breast, Mammography, Ultrasound, Biopsy, Diagnostic procedure, Lymphoma, Neoplasia
Authors:
E. Lopez Uzquiza1, A. Iturralde-Garriz2, A. De Diego Diez2, P. Alonso Bartolomé1, E. Ortega García1, P. Merino Rasillo1; 1Suances/ES, 2Santander/ES
DOI:
10.1594/ecr2015/C-1031
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 on the mammogram as a round or oval well-defined mass,
isodense or hypodense compared with breast parenchyma,
and containing a central area of hilar fat.
Lymph node cortical thickness and uniformity were the most important criteria for distinguishing between normal and abnormal nodes.
Normal lymph nodes have a reniform shape,
a uniformly hypoechoic cortex with a maximal thickness of 3 mm,
smooth margins,
and a central fatty hilum.
Findings of cortical thickness in excess of 3 mm,
eccentric thickening,
irregular margins,
and encroachment on or displacement of the fatty hilum are suggestive of a pathologic process.
All biopsies and fine needle aspirations were ultrasound-guided with a free hand approach.
Core needle biopsies were performed with an automated fourteen-gauge needle with a 22 mm throw (Acecut,
TSK,
Laboratory; Japan).
A minimum of three biopsy samples were obtained with additional samples collected at the discretion of the radiologist.