# Sonographic localisation of lymph nodes suspicious of metastatic breast cancer to surgical axillary levels

## TL;DR

This paper explains how ultrasound can locate breast cancer metastases in lymph nodes using specific anatomical levels.

## Contribution

The paper provides a detailed guide on sonographic techniques to identify and localize suspicious lymph nodes in breast cancer patients.

## Key findings

- Sonographic imaging helps identify and locate axillary lymph nodes suspicious of metastatic breast cancer.
- Axillary lymph nodes can be categorized into three surgical levels based on anatomical landmarks.
- Sonographic techniques can distinguish between benign and suspicious lymph nodes.

## Abstract

The axillary lymph node (LN) burden of breast cancer patients guides multidisciplinary management and treatment regimes. Sonographic imaging is used to identify the presence, number and location of axillary LNs suspicious of malignancy and used to guide nodal fine needle aspirations and biopsies. Axillary LNs suspicious of harbouring breast cancer metastasis can be localised to three surgical axillary levels, numbered according to their location relative to the pectoralis minor muscle and lymph flow. To sonographically identify and localise suspicious axillary LNs, an understanding of the axillary anatomy, muscular sonographic landmarks, surgical axillary levels, and the sonographic technique to image and distinguish between benign and suspicious LNs is required.

Sonographic imaging is used to identify the presence, number and location of malignant lymph nodes. Axillary lymph nodes suspicious of harbouring breast cancer metastasis can be localised to three surgical axillary levels. This paper will unpack the axillary anatomy, muscular sonographic landmarks, surgical axillary lymph node levels and the sonographic technique to image and distinguish between benign and suspicious lymph nodes.