Background: Axillary lymph nodes (ALNs) metastasis is very important for the 
prognosis of breast cancer cases, affecting their survival rate but until now, 
tissue biopsy is the only golden standard for definite diagnosis. The current 
work evaluates the feasibility of Diffusion Weighted Magnetic Resonance 
Imaging (DW-MRI) in prediction of ALN metastasis in breast cancer. 
Methods: A total of 300 ALNs were surgically excised from 30 women with 
confirmed as breast cancer. MRI with diffusion examination was performed and 
comparison between MRI findings with postoperative histopathology was done 
in lymph Nodes (LNs) with short axis diameter > 5 mm. 
Results: By imaging It was found that MRI with diffusion had comparable 
accuracies with LNs > 5 mm in size (accuracy in both conditions was 59%). 
Also, accuracy of adherent diffusion coefficient is better when its cutoff point 
for malignant LNs ≤ 0.90 than ≤ 0.80 (65.3% vs.61.7%; respectively). 
Conclusion: MRI is considering essential maneuver in preoperative LN 
evaluation of BC, MRI with diffusion and ADC values are showing accepted 
specificity and accuracy in LN assessment.