MRI Case 8

55 y/o F presents for diagnostic MRI to determine extent of disease. What is indicated by the arrow?


  • Group of lymph nodes that are the final step in lymph drainage through the axilla  
  • Receive lymph from level II nodes and drain into the subclavian lymphatic trunk and supraclavicular nodes, a path that ultimately leads to the thoracic duct on the left side of the thorax and the right lymphatic duct on the right side
  • Metastasis to this level automatically indicates N3 nodal staging (stage IIIC disease) 

Related Radiology Article: Ecanow JS, Abe H, Newstead GM, Ecanow DB, Jeske JM. Axillary staging of breast cancer: what the radiologist should know. Radiographics. 2013 Oct;33(6):1589-612.