Over the past 20 years, breast augmentation has become increasingly popular for enhancing breast size and correcting asymmetry. Saline implants were initially used, followed by silicone implants and autologous fat transfer. However, complications such as infection, implant failure and capsular contracture are common, while rare cases of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) exist.A woman in her 60s with no breast cancer risk factors underwent bilateral augmentation mammoplasty. Her preoperative imaging was unremarkable, and she was advised to regular follow-up but was lost for several years. She later presented with lumps in both breasts. Imaging revealed a benign lesion in the right breast, a malignant lesion in the left, left-sided axillary lymphadenopathy and bilateral implant rupture.Although rare, incidental breast cancer in reduction specimens should not be overlooked. While implant-associated malignancies are often lymphoma, other histological subtypes should also be considered.