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Pathological axillary lymph nodes detected at mammographic screening
E T Lim1, A O'Doherty, A D Hill
1Department of Histopathology, Merrion Unit, St Vincent's University Hospital, Elm Park, 4, Dublin, Ireland.
Clinical Radiology
|December 31, 2003
Summary
Abnormal axillary lymph nodes found during mammograms, even without a breast lesion, are rare but can indicate serious conditions like cancer. Further investigation, including biopsy, is crucial for accurate diagnosis.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Screening mammography aims to detect breast cancer early.
- Axillary lymph node assessment is part of breast cancer staging.
Purpose of the Study:
- To determine the significance of abnormal axillary lymph nodes detected on screening mammograms when no breast lesion is visible.
- To evaluate the diagnostic yield of investigating such findings.
Main Methods:
- A review of 23,707 screening mammograms identified 9 women with abnormal axillary lymph nodes and no breast lesion.
- Recall criteria included specific lymph node size, shape, density, and hilum characteristics.
- Diagnostic workup involved further imaging (mammography, ultrasound), clinical examination, and lymph node biopsy (needle core biopsy or open excision).
Main Results:
- Pathological diagnoses in the 9 women included metastatic breast carcinoma (2), malignant melanoma (1), lymphoma (2), tuberculosis (1), and benign conditions (3).
- Abnormal axillary lymph nodes without a visible breast lesion were found in 0.4 per 1000 screened women.
Conclusions:
- Abnormal axillary lymph nodes on screening mammograms, even without a concurrent breast lesion, are uncommon but can represent significant pathology.
- These findings warrant further investigation, including biopsy, to rule out malignancy or other serious conditions.