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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.