Objectives Ectopic breast tissue is present in 2 to 6% of women. Only one hundred and seventy one cases of ectopic breast cancer were described in the literature, reducing the available evidence.

Thus the aim of this case series is to report long-term outcomes in five cases treated at our institution.

Methods We report five cases of primary axillary breast carcinoma followed at our institution between 1999 and 2005.

Results The median age of our patients was 48 years old (33–60 years) and median follow up was 8 years( 4–10 years). Four times the ectopic breast tissue was located in the right axilla. The median tumor size was 25 mm (15–55 mm). Four of them had wide local excision and axillary lymph node dissection. Three of those patients had positive lymph nodes thus they had adjuvant chemotherapy, radiation therapy and hormonal therapy. The other patient with negative lymph node had adjuvant radiation therapy and hormonal therapy. One of the patients had a positive supraclavicular lymph node and received Radiation therapy chemotherapy and hormonal therapy after four years she had a loco-regional relapse and was treated with mastectomy and chemotherapy. One patient had a distant relapse after two years of follow up and received chemotherapy. The three other patients were free of relapse during their follow up period.

Conclusions Primary axillary breast carcinoma is a rare entity. Despite the paucity of literature, our findings and authors recommendations suggest that local excision can be performed safely with promising outcomes in this subset of patients.