Detection of an occult intramammary recurrence of breast cancer with positron emission tomography: A case report

Magnetic resonance imaging (MRI) and whole-body positron emission tomograph y (PET) with 18-fluoride marked deoxyglucose were performed in the follow-u p of a 37-year-old patient after modified radical mastectomy with axillary lymph node dissection, adjuvant chemotherapy and radiotherapy for cancer of the right breast. PET showed two foci of glucose accumulation in the right breast and parasternally. These foci had been described as consistent with scar tissue in the preceding MRI scan. The foci were marked under MRI guid ance and excised. Histology showed a 1.4-cm recurrence. This case, in which the intramammary recurrence would have been missed with conventional diagn ostic modalities, suggests that PET may be useful in the follow-up of patie nts after breast-sparing surgery, particularly to distinguish scar tissue a nd benign sequelae of surgery and radiotherapy from recurrence in the breas t.