- Ductal Carcinoma in Situ (DCIS) is defined as the presence of cancerous cells in the breast duct or lobule in the absence of a breach of the basement membrane. [1,2] It is associated with less than a 4% incidence of nodal metastases. We report the case of an 83-year-old woman who presented with a solitary left axillary lump. On investigation, she was found to have a left axillary nodal mass with an occult breast primary. She underwent modified radical mastectomy with final histopathology showing DCIS in the breast with invasive ductal carcinoma in the axillary lymph node (Immunohistochemistry: Estrogen receptor (ER) and Progesterone Receptor (PR) negative/Her2 Receptorpositive). At the end of a year's follow-up after surgery, the patient has finished 17 cycles of trastuzumab and is still alive and disease-free.