Abstract Background: Primary breast lymphoma (PBL) is an exceedingly rare extranodal malignancy that frequently mimics breast carcinoma on clinical and radiological examination, posing a significant diagnostic challenge. Case presentation: We report a case of a 39-year-old Chinese woman who presented with two palpable right breast masses. Imaging revealed suspicious lesions classified as Breast Imaging-Reporting and Data System 4A, prompting surgical excision and biopsy.