Breast specific gamma imaging (BSGI) is a nuclear medicine breast imaging technique. The sensitivity of BSGI is unaffected by post-operative scars or implants, and thus, BSGI is helpful for the differential diagnosis of postoperative recurrence. Here, the authors report a case of diffuse chest wall recurrence on the side of radical mastectomy that was not detected by BSGI, but was detected using other nuclear medicine imaging techniques.