| Summary: | The identification of axillary lymph node metastases in breast cancer patients is a critical factor in determining the stage, deciding the treatment modality, and predicting the prognosis. Over the years, axillary staging has evolved from a radical axillary lymph node dissection to a more conservative sentinel lymph node biopsy. The main goal of axillary imaging techniques is to identify metastatic lymph nodes with optimal accuracy, high enough to initially select patients for an upfront lymph node dissection. Features suggestive of an axillary lymph node metastasis may be seen with a range of imaging modalities. On the other hand, ultrasonography is the method of choice for evaluating the node morphology and allowing image-guided interventions of abnormal nodes. Gray-scale ultrasonography is not perfect on its own. Newer techniques, such as elastography or contrast-enhanced ultrasonography, have shown promise in identifying axillary lymph node metastases. This review provides a comprehensive overview of ultrasonography for an axillary lymph node assessment in breast cancer patients.
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