Patient information: A 38-year-old female presented with a mass in her right axilla. It was accidently found while visiting clinic for her routine follow-up of a mass in her right breast which she had for 5 years. She was G2P2 and lactated for 3 years. She did not have any chronic illnesses. Her surgical history included a left breast lumpectomy for a benign mass that was performed 20 years prior to this report. Her family lacked a history of cancer. Clinical findings: The patient's right breast mass was palpable, firm, freely mobile, with mild tenderness. The lump in her axillary area was palpable and hard. Diagnostic approach: The patient's routine laboratory findings were normal. Ultrasound (US) examination revealed a benign mass (U2) measuring 9*6 mm in the left breast at 4 o'clock position in a middle depth (35 mm), two circumcised small foci (U2) of about 5 mm in the right breast at a middle depth with no suspicious features, and an oval lymph node in the level I axilla measuring 12*6 mm with blurred and unclear fatty hilum, suspicious for malignancy. Magnetic resonance imaging (MRI) showed a 13 mm circumcised mass in the left breast 14 mm from the skin at 4 o'clock direction, two small foci (5 and 4 mm) in the right breast with homogeneous enhancements which was not restricted on DWI/ADC with type I (slow raising and persistent delayed phase benign findings), and an oval lesion measuring 12*7 mm in the level I axilla with no fatty hilum and low signal on T1WI, an intermediate signal in T2WI, high signal on Dixon water, with heterogeneous enhancements suggesting abnormal nodes (). Fine needle aspiration (FNA) of the axillary mass suspected malignancy of CUP type. Core needle biopsy was then advised which revealed benign non-proliferative fibrocystic changes with fibroadenomatoid hyperplasia in the right breast mass and FA in the right axillary lymph node. Therapeutic intervention: Under general anesthesia, right breast lumpectomy and right axillary mass excision were performed to remove the masses. Post-operative histopathology examination showed two fibroadenomas with proliferative fibrocystic changes in the right breast and a fibroadenoma with benign ectopic breast tissue in the right axilla. Follow-up and outcome: The operation was uneventful and the patient was discharged in good health.