Metastatic intramammary lymph node

Last revised by Daniel J Bell on 6 Mar 2020

A metastatic intramammary lymph node refers to an intramammary lymph node involved with metastatic or malignant disease.

Radiographic features

Breast ultrasound

Sonographic features that suggest metastatic involvement include 4:

  • disappearance or loss of central echogenic hilar region
  • marked hypoechogenicity
  • increase in size
  • lobulated outer contours

Different authors put different emphasis on cortical measurement and nodal morphology to predict malignant nodal involvement.

Cho et al. 2 developed a grading system of cortical thickness by proposing a thickness of 2.5 mm or more as an indication for cytology/histology assessment.

Bedi et al. 3 developed these categories:

  • type 1: without visible cortex
  • type 2: cortex ≤3 mm
  • type 3: cortex >3 mm
    • frequently reactional changes
  • type 4: entirely lobulated cortex
    • considered as probably benign
  • type 5: with focal lobulation
    • suspicious, indication for biopsy
  • type 6: completely hypoechogenic, without hilum
    • suspicious, indication for biopsy

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Cases and figures

  • Case 1: lymphoma
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