Abstract: Occult breast cancer (OBC) is an uncommon type of breast cancer,with palpable masses in the axillary area as the initial symptom.We report a case of OBC with HER2 genetic heterogeneity and discuss the impact of an unusual HER2 amplification pattern.A 56-year-old female was discovered a palpable mass in the right axillary area.She underwent a lymph node excisional biopsy at another hospital approximately one month before referral to our hospital service for further evaluation.The biopsy showed lymph tissue with tumor cell infiltrating in the form of sheets or nests.