A 60-year-old woman underwent lumpectomy and axillary node dissection for a right breast cancer (T1c, N0, M0, stage I) in 1991 (see breast cancer). She had postoperative radiotherapy to the breast and 8 cycles of CMF. In 1996 she presented with and enlarged right supraclavicular lymph node which was positive for metastatic breast cancer. This was successfully treated under MB-381 protocol, including supraclavicular radiation. On routine follow-up examination in January 2001, she was found to have a firm 1.5 cm right scalene node that showed metastatic breast cancer on fine needle aspiration. She was enrolled in the taxotere plus flavopiridol trial, but the lymph node continued to enlarge over the succeeding nine months. This CT cut shows the lobulated 2.5 cm lesion at the junction of right internal jugular and subclavian veins. There was no evidence of metastatic disease elsewhere.
An MRI was obtained to assess whether the brachial plexus was involved with the tumor. This coronal cut shows the lesion impinging on the confluence of the right internal jugular and subclavian veins.
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