A case of chest wall recurrence of breast cancer detected by scintimammography is presented. A 63-year-old woman who had a right mastectomy for breast carcinoma 24 years earlier was evaluated for left axillary adenopathy. Although it was suspected that a second primary malignancy had developed in the left breast, results of mammography and magnetic resonance imaging of that breast were negative. Scintimammography performed with Tc-99m sestamibi confirmed a normal left breast but revealed a lesion in the right chest wall at the site of the previous mastectomy. This was surgically confirmed as recurrent breast carcinoma, which subsequently altered patient management.