Breast cancer developing in a preexisting scar is rare and reports are anecdotal. There are reports of breast cancer arising from surgical site scars occurring as a result of breast biopsies, lumpectomies, and abscess drainages.6- 8 In addition, there are reports of breast cancer arising in thoracotomy scars if it were to traverse through the breast.6,7 This should be considered a midline breast cancer developing from the previous sternotomy scar, which would then explain the central location and bilateral nodal disease. In this case, the possibility of breast cancer arising from 1 side (probably right) and crossing midline is less likely because the scar tissue would act as a barrier, at least temporarily. However, this could be considered a less likely but alternative possibility wherein the disease developing in the medial part of the breast near the midline has become locally advanced. The patient was scheduled to undergo neo-adjuvant chemotherapy followed by surgery and radiation.