Abstract
Occult breast cancer (OBC) is a rare presentation of breast cancer, characterised by evidence of metastasis to axillary lymph nodes without a clear radiological lesion in the breast. Contralateral axillary metastasis (CAM) in breast cancer is another rare presentation, with various differentials. This case report presents a 67-year-old female with left axillary metastasis from an OBC with synchronous CAM. This case highlights the complexities of both rare presentations in a single patient and discusses the pertinent therapeutic recommendations from current literature and guidelines.