Figure 1. Breast-conserving surgery (BCS) plus sentinel node biopsy (SNB) was performed 18 years ago (Patient 1). (A, B) Planar images and at 15 min and at 3 h, respectively. (C–E) All SPECT/CT images at 3 h. (A) No obvious second sentinel lymph node exists (SLN). (B) Second sentinel nodes (SNs) were detected in the contralateral (red arrow) and the ipsilateral internal mammary lymph node (LN) (dotted red arrow). gThe blue dotted line indicates the sternum. (C) Contralateral internal mammary LN was detected (red arrow). (D) Intramammary LN had a dominant accumulation of isotope (dashed red arrow) and ipsilateral axillar LN (brown solid arrow). (E) Ipsilateral internal mammary LN was detected (dotted red arrow).