The incidental findings/artifacts identified on myocardial perfusion imaging (MPI) often warrant further evaluation to rule out possible malignant pathologies. In this case report, we describe an elderly lady who was advised to undergo MPI for cardiac risk stratification prior to a non-cardiac surgery. Her MPI showed a large-sized infarct. In addition, a nodule on the left side of her chest that demonstrated increased isotope uptake was identified incidentally. Further evaluation of this lesion revealed a histopathological diagnosis of intraductal carcinoma of the breast. This case highlights the importance of reporting and investigating all suspicious incidental MPI findings.