Metastatic intramammary lymph node
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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