In such situations, further investigation with axillary US and possible US-guided biopsy may be helpful. Digital Breast Tomosynthesis Diagnostic There is insufficient data to support the use of DBT as the single initial imaging test for an axillary palpable mass, even though a portion or all of the axillary mass may be visible on DBT. If there is a personal history of breast cancer or clinical suspicion of axillary tail breast carcinoma, DBT, as an adjunct test to axillary US, can provide a global assessment of the ipsilateral breast and also assess for other suspicious findings such as microcalcifications associated with the palpable axillary mass. DBT allows better characterization of lesions and addresses some of the limitations associated with standard 2-D mammography [24-27]. Imaging of the Axilla If the unilateral axillary mass is suspicious for metastatic adenopathy from a primary breast cancer or occult breast cancer, the reported data from multicenter trials for DBT use in this population, in addition to digital mammography, was associated with an increased primary breast cancer detection rate compared with digital mammogram alone [28]. DBT, in addition to digital mammography, demonstrated best performance gains in women ages 40 to 49 years [29]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is not beneficial for assessing an axillary mass of unknown etiology as the initial imaging assessment because of its low yield to detect an occult primary malignancy without first confirming that the unilateral axillary mass is of malignant etiology [30,31]. Less than 1% of breast cancers initially present as axillary adenopathy [32,33]. If FDG-PET/CT incidentally detects an FDG-avid lymph node, then axillary US is helpful to characterize the nodal morphology and guide biopsy, if warranted.
Imaging of the Axilla. In such situations, further investigation with axillary US and possible US-guided biopsy may be helpful. Digital Breast Tomosynthesis Diagnostic There is insufficient data to support the use of DBT as the single initial imaging test for an axillary palpable mass, even though a portion or all of the axillary mass may be visible on DBT. If there is a personal history of breast cancer or clinical suspicion of axillary tail breast carcinoma, DBT, as an adjunct test to axillary US, can provide a global assessment of the ipsilateral breast and also assess for other suspicious findings such as microcalcifications associated with the palpable axillary mass. DBT allows better characterization of lesions and addresses some of the limitations associated with standard 2-D mammography [24-27]. Imaging of the Axilla If the unilateral axillary mass is suspicious for metastatic adenopathy from a primary breast cancer or occult breast cancer, the reported data from multicenter trials for DBT use in this population, in addition to digital mammography, was associated with an increased primary breast cancer detection rate compared with digital mammogram alone [28]. DBT, in addition to digital mammography, demonstrated best performance gains in women ages 40 to 49 years [29]. FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is not beneficial for assessing an axillary mass of unknown etiology as the initial imaging assessment because of its low yield to detect an occult primary malignancy without first confirming that the unilateral axillary mass is of malignant etiology [30,31]. Less than 1% of breast cancers initially present as axillary adenopathy [32,33]. If FDG-PET/CT incidentally detects an FDG-avid lymph node, then axillary US is helpful to characterize the nodal morphology and guide biopsy, if warranted.