Axillary Lymph Nodes on Mammography

Differentiating benign from malignant lymph nodes on mammography is difficult due to the wide overlap in appearance. Three characteristics point toward malignancy and should prompt recommendation of biopsy:

• Nonfatty lymph nodes with microcalcifications. Intranodal gold in patients with RA who have received gold therapy may have a similar appearance
• Nonfatty lymph nodes with ill-defined or spiculated margins
• Nonfatty lymph nodes longer than 45 mm
• Documented increase in size or density

References

Walsh R, Kornguth PJ, Soo MS, Bentley R, DeLong DM. Axillary lymph nodes: mammographic, pathologic, and clinical correlation. AJR Am J Roentgenol. 1997 Jan;168(1):33-8.