Ultrasono-anatomy for evaluation of the local lymphatic groups of the mamma.

Sonography has been established as an important adjunct to current diagnostic techniques for the assessment of mammary lymph nodes. Although this method is widely used, no reproducible standard procedure which is equally applicable to the examination of all relevant lymphatic groups has been developed to date. Healthy subjects (n = 50) were examined in an attempt at defining sonographic scanning levels for optimum visualization of anatomic reference landmarks. Images were acquired with a 7.5-MHz linear-array transducer. Anatomic cross-sections of the same level as imaged by sonography were used to identify important details. Unique structures close to the lymph nodes could be identified by sonography, it was not possible, however, to differentiate normal lymph nodes. The correct assessment of lymph drainage areas is therefore possible only if the sonographic level is clearly defined and if the examiner is familiar with the topographic relationships between the depicted structures. By presenting a reproducible examination technique as well as anatomic details, this study aims at avoiding false interpretations and increasing the efficacy of sonographic exploration. The authors believe that this simple and hardly time-consuming technique can contribute to a comprehensive evaluation of the lymph drainage areas of the breast.