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Imaging the Axilla

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Breast Imaging

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

The presence of axillary lymph node metastases remains one of the most important prognostic factors in breast cancer. Axillary ultrasound is used routinely in clinical practice, with both morphological features and cortical thickness prompting selective needle biopsy of lymph nodes. Ultrasound and axillary core needle biopsy have a positive impact on the management of patients with breast cancer, as preoperative identification of axillary metastases allows the patient to proceed directly to full axillary lymph node dissection, avoiding unnecessary sentinel lymph node biopsy. The performance characteristics of axillary US vary widely in the literature, and its clinical utility has been called into question with the advent of the American College of Surgeons Oncology Group Z0011 trial. Subsequently, focus has been on imaging to improve discrimination between limited and advanced nodal disease as well as improved targeting of the sentinel lymph node. The timing of sentinel lymph node biopsy and the use of imaging in the setting of neoadjuvant chemotherapy have also been a subject of much debate. While US is the most widely used technique for axillary assessment, multimodality imaging techniques including MRI and PET-CT have been investigated to provide nodal staging information.

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  1. Cambridge University NHS Foundation Trust, Cambridge, UK

    Fleur Kilburn-Toppin

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  1. Fleur Kilburn-Toppin
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Correspondence to Fleur Kilburn-Toppin .

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Editors and Affiliations

  1. Department of Radiology, Medical University of Graz, Graz, Austria

    Michael Fuchsjäger

  2. Department of Radiology, University of California, Davis (UCD) School of Medicine, Sacramento, CA, USA

    Elizabeth Morris

  3. Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria

    Thomas Helbich

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Kilburn-Toppin, F. (2022). Imaging the Axilla. In: Fuchsjäger, M., Morris, E., Helbich, T. (eds) Breast Imaging . Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-94918-1_13

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  • DOI: https://doi.org/10.1007/978-3-030-94918-1_13

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