PMC6480983_01
Axial PET scans. A and B were acquired prior to chemotherapy, while C and D were acquired after 6 cycles of CHOP. (A) Demonstrates hypermetabolic soft tissue densities around the breast implant, while (B) shows a hypermetabolic right axillary lymph node. (C and D) Show residual FDG-avidity in the right chest and axilla, respectively.
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An initial positron emission tomography/computed tomography scan (PET/CT; Figure 1) demonstrated 4 abnormal hypermetabolic soft tissue densities surrounding the right breast implant (SUV [standardized uptake value] maximum 4.8) and a 1.3 x 0.5 cm hypermetabolic enlarged right axillary lymph node (SUV maximum 3.2). Post-chemotherapy PET/CT (Figure 1) showed FDG-avidity in the right axilla (SUV maximum 2.4) and right chest (SUV maximum 2.1).
Radiation treatment plans: (A) Right chest, axilla, and supraclavicular lymph node plan (3000 cGy) and (B) Cone down to the right axilla (600 cGy).
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She received 3000 cGy over 15 fractions to the right chest, right axilla, and right supraclavicular lymph nodes, followed by a cone down consisting of 600 cGy in 3 fractions delivered to the right axilla (Figure 2).