本研究旨在探索乳房X光检查在乳腺癌腋窝淋巴结（ALN）评估中的新地位，即腋窝视图。患者前瞻性入组并安排在手术前进行乳房X光检查。研究的成像模式包括乳房 X 线摄影的内侧倾斜 (2D-MLO) 和腋窝视图 (2D-腋窝) 以及数字乳房断层合成的腋窝视图 (3D-腋窝)。分析影像学和病理学之间ALN数量的相关性。通过 AUC 分析诊断性能。纳入了 75 名患者。腋窝视图显示更大、更清晰的腋窝区域。 2D/3D 腋窝视图下检测到的 ALN 总数显着高于 2D-MLO 视图下检测到的 ALN 总数（4.6 vs. 2.5，P < .001；5.6 vs. 4.6，P = .034）。 2D/3D-腋窝视图下检测到的阳性 ALN 数量与病理证实的转移性 ALN 之间的相关性强于 2D-MLO 视图（Pearson 相关系数：0.7084、0.7044 和 0.4744）。 3D-腋窝视图下检测到 ≥5 个阳性 ALN 的病例比例显着高于 2D-MLO 下（38.2% vs. 14.7%，P = .028）。在 ALN 评估中，超重和肥胖组的 AUC 值高于体重不足和瘦削组，但差异不显着（2D-MLO：0.7643 vs. 0.6458，P = .2656；2D-axilla：0.8083 vs. 0.6586，P = . 1522；3D 腋窝：0.8045 与 0.6615，P = .1874）。这种差异在腋窝视图中更为明显。在乳腺癌乳腺X线摄影显示的腋窝范围方面，腋窝视图比传统MLO视图表现出优势。需要更大样本量的进一步研究。版权所有 © 2023 Elsevier Inc. 保留所有权利。

This study aimed to explore a novel position of mammography named axilla view in axillary lymph node (ALN) evaluation in breast cancer.Patients were prospectively enrolled and scheduled for mammography before surgery. Investigated imaging patterns included mediolateral oblique (2D-MLO) and axilla view (2D-axilla) of mammography, and axilla view of digital breast tomosynthesis (3D-axilla). The correlation of ALN numbers between imaging and pathology was analyzed. Diagnostic performance was analyzed via AUC.75 patients were included. A larger and clearer axillary region was displayed in axilla view. The total number of ALNs detected under 2D/3D-axilla view was significantly higher than that under 2D-MLO view (4.6 vs. 2.5, P < .001; 5.6 vs. 4.6, P = .034). Correlations between number of positive ALNs detected under 2D/3D-axilla view and pathologically confirmed metastatic ALNs were stronger than 2D-MLO view (Pearson correlation coefficients: 0.7084,0.7044 and 0.4744). The proportion of cases with ≥5 positive ALNs detected under 3D-axilla view was significantly higher than that under 2D-MLO (38.2% vs. 14.7%, P = .028). The overweight and obese group showed a higher AUC value than the underweight and lean group in ALN evaluation, although not significantly (2D-MLO: 0.7643 vs. 0.6458, P = .2656; 2D-axilla: 0.8083 vs. 0.6586, P = .1522; 3D-axilla: 0.8045 vs. 0.6615, P = .1874). This difference was more pronounced in axilla view.Axilla view exhibited advantages over conventional MLO view in the extent of axilla displayed by mammography in breast cancer. Further studies with larger sample sizes are needed.Copyright © 2023 Elsevier Inc. All rights reserved.