Breast cancer with involvement of the skin. This patient originally presented in 2007 for a routine mammogram. She had an area of microcalcifications suspicious for malignancy, biopsy recommended. The patient elected to not have a biopsy and agreed to return for another mammogram in 6 months to 1 year. Unfortunately, the patient was not seen again until 6/2017 when she presented with a large (10cm) palpable mass and the skin involvement shown here. The patient chose to have a radical mastectomy with an axillary dissection.