Ultrasonography for Staging Axillary Lymph Node in Breast Cancer Patients

The identification of axillary lymph node metastases in breast cancer patients is a critical fac-tor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially se-lect patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing im-age-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.