Investigation of Lung CT Scan Findings in Axillary, Mediastinal, and Hilar Lymph Nodes Involvement in Breast Cancer Patients Referring to Dr. Masih Daneshvari Hospital

Understanding lymphadenopathy pattern in breast cancer is essential for precise and timely diagnosis and treatment. In this article we study the anatomic distribution and morphologic characteristics of lymphadenopathy in breast cancer using spiral computed tomography scan.
The spiral computed tomography images of 100 consecutive patients with diagnosis of breast cancer; admitted to Masih Daneshvari Hospital Tehran Iran over a 2-year period; were assessed.
Mediastinal (39%), axillary (22%) and internal mammary lymph nodes (7%) were most frequently involved. In all these regions, lymphadenopathy was more common in mastectomy/lumpectomy group compared to non- mastectomy/lumpectomy group. In both groups, mediastinal lymph nodes were most commonly involved. Within the mediastinum, pulmonary hilar (27%) and paratracheal (22%) regions were most frequently involved. Cavitation and irregular margins were only noted in axillary lymph nodes .Calcification without history of previous radiation therapy was noted only in mediastinal (pulmonary hilar and lower paratracheal) lymph nodes. Lymph node involvement was most frequently noted in subcarinal and right lower paratracheal lymph nodes. In all patients, internal mammary lymphadenopathy was noted in the absence of axillary lymphadenopathy. Concurrent internal mammary and other mediastinal lymphadenopathy was observed in 3% of patients.
The study showed mediastinal, axillary and internal mammary lymph nodes are most commonly affected in breast cancer. So, lymphadenopathy in these regions in breast cancer patients requires further evaluation; including biopsy; to exclude metastasis.