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Fig. 2B. —42-year-old woman who developed recurrence in right mastectomy scar 21 months after surgical resection of infiltrating ductal carcinoma. Results of conventional staging studies (chest CT and bone scan) were negative (not shown). Patient was being considered for aggressive local therapy (surgery and radiation). Coronal image from FDG PET shows uptake in mediastinum (arrows; maximum SUV, 2.8). Malignant nodal involvement in mediastinum was confirmed by mediastinoscopy. Because FDG PET indicated more widespread disease than conventional staging examinations, therapeutic plan was altered from primarily local with adjuvant systemic therapy to systemic therapy only.