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The RSNA designates this journal-based SA-CME activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. The RSNA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. ■ Discuss the role of axillary imaging in selecting a proper candidate for sentinel lymph node biopsy (SNLB) in patients planning upfront surgery versus those planning neoadjuvant chemotherapy treatment ■ Describe how axillary nodal disease burden can be assessed with US and MRI ■ Describe image findings of axillary lymphadenopathy

Online supplemental material is available for this article.Īfter reading the article and taking the test, the reader will be able to: As methods of axillary nodal evaluation evolve, breast radiologists and surgeons must work closely to maximize the potential role of imaging and to provide the most optimized treatment for patients. Efforts continue to develop prediction models that incorporate imaging features to predict nodal disease burden and to select proper candidates for SLNB. For the node-positive patients treated with neoadjuvant chemotherapy, restaging of the axilla with US and MRI and targeted axillary dissection in addition to SLNB is highly recommended to minimize the false-negative rate of SLNB. Thus, assessment of nodal disease burden to guide multidisciplinary treatment decision making is now considered to be a critical role of axillary imaging and can be achieved with axillary US, MRI, and US-guided biopsy. Emerging evidence indicates that axillary LN dissection may be avoided in selected patients with node-positive as well as node-negative cancer. Axillary management in patients with breast cancer has become much less invasive and individualized with the introduction of sentinel LN biopsy (SLNB). Axillary lymph node (LN) metastasis is the most important predictor of overall recurrence and survival in patients with breast cancer, and accurate assessment of axillary LN involvement is an essential component in staging breast cancer.

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