Cutaneous metastatic breast cancer is rare and accounts for 0.7% of all breast cancer metastasis, usually to the breast skin/chest wall skin. However we present a very rare case of cutaneous metastatic breast cancer in the head and neck region - scalp. Seventy four year old female had a bilateral mastectomy for right sided oligometastatic breast cancer completing 4 cycles of adjuvant chemotherapy. On her initial work up her PET scan showed a small focal scalp FDG avidity potentially reported as a primary cutaneous malignancy. This area was biopsied approximately 12 months later by the GP as it was growing as a potential adnexal tumour. It was formally excised by the Plastic and Reconstructive Surgery team with histopathology showing a cutaneous metastatic moderately invasive breast cancer. The take home message from this case was that even distant cutaneous uptake i.e. in the scalp on PET scan may represent a metastatic breast cancer.