COPYRIGHT © 2018 by the Society of Nuclear Medicine and Molecular Imaging. 18F-FDG uptake in enlarged lymph nodes is always suspicious, especially in cancer patients. We report a case of hypermetabolic internal mammary lymphadenopathy in a breast cancer patient who was previously treated with bilateral mastectomy and implants. The abnormal nodal uptake turned out to be due to foreign body-induced inflammation, as confirmed histopath-ologically. Vigilant PET interpretation is required in breast cancer patients who have evidence of breast implant rupture.