There is increasing interest in the radiological diagnosis of axillary lymp
h nodes in patients with breast cancer, especially in the preoperative diag
nosis of metastatic nodes. Both CT (computed tomography) and MRI (magnetic
resonance imaging) are cross-sectional imaging methods that produce high-qu
ality images of the axilla. MRI also uses contrast enhancement profile, for
example in imaging of breast lesions. Few studies have been published on t
his subject, but the latest have shown high sensitivity and specificity (CT
93.8 and 82.1%, respectively; MRI 90 and 82%, respectively), although, bot
h CT and MRI are restricted to imaging only. US (ultrasound) is widely spre
ad and is fast and accurate with high resolution. Sensitivity and specifici
ty vary (68.2-92% and 90-100%, respectively). Most importantly, there is th
e possibility of US-guided FNAB (fine-needle aspiration biopsy) of patholog
ical nodes, which increases the specificity. Initial results with colour Do
ppler are promising, but a recent study has shown that the presence of colo
ur Doppler flow signal is highly non-specific. Other parameters such as flo
w pattern and distribution may prove to be of value in this method. Today,
the method of choice for the daily routine is US in conjunction with FNAB.