Figure 8. Breast cancer in a 72-year-old woman. CT scan obtained at the level of the great vessels shows multiple left subpectoral nodes (level II) (white arrow), a left internal mammary node (black arrow), and a right paratracheal node (arrowhead). A left pleural effusion and multiple pulmonary metastases are also present. These findings are defined as stage IV disease due to the pulmonary metastases.