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Introduction: Lung cancer is the most common cause of cancer related death worldwide. Mostly these tumors present with cough, chest pain weight loss. However, presentation as breast mass and cardiac tamponade is very rare. Results: We are presenting a rare case of breast metastasis from primary lung cancer. This case presented as cardiac tamponade adding to the diagnostic dilemma. Conclusion: The importance of this case is to highlight molecular profiling as an applicable tool to distinguish extra-mammary metastasis that masquerade as mammary neoplasm thereby preventing unnecessary need of surgery and radiation therapy.