Lymphoscintigraphic SPECT/CT localization of a sentinel node in an unusual position: Rotter's node

A 57-year-old woman with infiltrating ductal carcinoma of the right breast underwent lymph node scintigraphy with Tc-99m-nanocolloid for preoperative sentinel node localization. On planar images, an unusual pattern of lymphatic drainage was observed. We performed a chest SPECT/CT, revealing an interpectoral sentinel node, ie, Rotter's node. The patient underwent radioguided surgery and the sentinel node was located intraoperatively, and found to be disease-free. SPECT/CT fusion techniques have enhanced precision in locating sentinel nodes, enabling the surgeon to shorten surgical times.