The patient on the left was a 44 year old female who had complained of right breast fullness and discomfort from an axillary nodule. An initial mammogram was negative. Over the following six months two additional mammograms were performed and were both negative. A fine needle biopsy of the axillary nodule was subsequently performed and demonstrated carcinoma. An ultrasound guided biopsy of an 8 mm breast lesion was negative. A FDG PET exam was then performed and revealed extensive metastases to axillary and supraclavicular lymph nodes, as well as the primary lesion in the right breast (black arrow).