Lorena Picori, Davide Donner, Giuseppe Carbone, Paola Feraco, Carlo Ress, Carlos Garciaetienne, Franca Chierichetti
Lymphatic drainage of the breast occurs mainly in ipsilateral axillary nodes, but up to 20–30% of cases may present drainage to other locations, although it is usually coupled to ipsilateral axillary nodes. Contralateral axillary drainage in daily clinical practice is very rare (0-2%), even more without associated ipsilateral drainage. We present the case of a 71-year-old woman with a personal history of ductal/lobular carcinoma at 49 years on the left breast and a second primary invasive lobular carcinoma in the right breast. Preoperative lymphoscintigraphy showed absence of lymphatic drainage in the ipsilateral axilla but unusual lymphatic drainage was detected in the contralateral Rotter’s lymph nodes as confirmed by SPECT/TC imaging.