This study evaluated the use of pre-chemo MRI of axillary lymph nodes (aLNs) to detect metastasis in breast cancer with PET and pathology as reference standards. PET versus pathology reports agreed 87% for presence of disease in the aLNs, while PET and MRI reports agreed 93%. We found good agreement between MRI and PET scores (Cohen’s Kappa 𝜅= 0.39, p=10-5). The MRI sensitivity, specificity, NPV and accuracy were 66.1%, 72.1%, 73.1% and 69.9%, respectively. Although improvement is needed, MRI staging of aLN is possible and practical. This approach may prove helpful in diagnosis and treatment planning of breast cancer patients.