Sonographic Assessment of Axillary Lymph Nodes After a Mammographically Recommended Breast Sonogram for Women 55 Years and Older: A Feasibility Study

Sonographic guidelines have been provided for assessing lymph nodes both in the axilla and other areas of the body. The objective of this study was to determine the feasibility of using sonography and Doppler to provide diagnostic nodal information for women 55 years and older. The authors conducted a retrospective longitudinal study of a group of women 55 years and older who provided their prior health histories, mammography, and sonogram results, as well as eventual pathology reports, to help establish the value of Doppler measurements, nodal dimensions, and subjective assessment data collected at the time of the breast sonogram. Each patient consented to allow 15 minutes of scanning of her axilla to evaluate three lymph nodes. Fifty-two women provided data points that were captured and compared to published guidelines, such as longitudinal/diameter (L/D) ratio, resistive index (RI), and Stavros's subjective grading scale. The longitudinal axis compared to the diameter of a node (L/D ratio), shape, and RI was statistically correlated with published guidelines. Sonographic measures and Doppler assessment of axillary lymph nodes are feasible, and continued research could result in a reliable set of parameters that could be used as an economical, noninvasive imaging technique for possible staging of women 55 years and older.