The breast imager’s approach to non-mammary masses at breast
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Ultrasonography (US) of the breast and axilla is primarily used to evaluate a symptomatic patient or to further investigate findings identified with other imaging modalities. Breast imagers are generally familiar with US evaluation of level I, II, and III axillary lymph nodes in the diagnosis and staging of breast cancer. However, the axilla contains nonlymphatic tissue as well, including muscle, fat, and vascular and neurologic structures, and anatomically the breast lies on the chest wall. Therefore, lesions of nonmammary and non–lymph node origin in the axilla or chest wall are not infrequently encountered during US evaluation of the breast or axilla. Understanding the anatomy of the chest wall and axilla and using a systematic US approach will help radiologists expedite accurate diagnosis, suggest optimal additional imaging, and streamline appropriate clinical referral. Key imaging features of nonmammary non–lymph node masses are highlighted, and case examples are provided to illustrate these features.

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