Fig. 1.

A 54 years, menopaused woman with an invasive ductal carcinoma of the right breast, grade 3, ER-, PR-, HER2 + . Examination and palpation show a mass of 80 mm, with inflammation of the skin, fixed axillary lymph nodes metastasis and no supraclavicular lymph nodes: TNM classification before PET/CT is cT4d cN2a cM0 (stage IIIB). PET/CT shows the primary breast cancer with axillary lymph nodes (level I, II and III), supra-clavicular and internal mammary lymph nodes: TNM classification after PET/CT is T4 N3c M0 (stage IIIC). PET/CT fusion images show FDG uptake in the primary tumor and in internal mammary lymph nodes