Metastatic intramammary lymph nodes: mammographic and ultrasonographic features

Objective: To evaluate the mammographic and ultrasonographic findings in pa tients with intramammary lymph node (IMLN) involvement in breast cancer. Ma terials and methods: The mammograms of 1655 histopathologically proven brea st cancer cases diagnosed during the last 10 years were retrospectively rev iewed. There were 16 cases in which metastasis to intramammary lymph nodes was suspected mammographically and proven histopathologically. The clinical and radiological features of these 16 cases were evaluated. Results: On ma mmograms, the involved lymph nodes were all Well Circumscribed, homogeneous , oval or round opacities in the upper outer quadrant of the breast. They w ere all larger than 1 cm in size. On US, they were seen as well circumscrib ed, homogeneously hypoechoic masses with mild acoustic enhancement. In one case, besides enlargement, development of malignant microcalcifications was seen inside the node in the follow up period. In another case with IMLN me tastasis, the primary focus of the breast cancer could not be detected eith er mammographically or histopathologically. So the case was accepted as occ ult breast carcinoma. All of the primary tumors detected were invasive hist opathologically and their sizes varied between 1-6 cm. (mean, 3 cm). Conclu sion: The involvement of the IMLN can be suspected with mammographic and ul trasonographic features. Metastatic disease from breast cancer to IMLN may be the first clinical and/or radiological sign of breast cancer. (C) 2001 E lsevier Science Ireland Ltd. All rights reserved.