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Both benign and malignant conditions related to regional or systemic disorders could be included in the differential diagnosis of bilateral breast edema. Some of them are often unilateral, including stromal infiltration and lymphatic obstruction presented in “peau d’ orange”, which is the usual presentation of breast cancer. However, the term “idiopathic” could be included in the spectrum of diagnoses. Here, we present a woman of 78 years old who came into our breast unit with a bilateral, painless edema of the breasts (appeared one month ago). Clinical examination revealed that both breasts were swollen with widespread erythema and the appearance of an orange peel/“peau d’ orange”. On palpation, the breasts were not sensitive, and no tumor was palpable. However, clinically palpable lymph nodes were found in both axillas. Her temperature was normal. The breast edema could not be explained from her medical history nor the medications taken. Breast ultrasound, Mammography and Magnetic Resonance Imaging were non-conclusive (BI-RADS 0) and bilateral core biopsy was negative for cancer. Anti-inflammatory plus antibiotic therapy was prescribed for 10 days and at the end of treatment, regional redness and edema were disappeared and reduced, respectively. Total recovery was found one month after the initial findings. It can be concluded that bilateral breast edema is correlated to regional or systemic conditions or it is presented as an “idiopathic” disorder of unknown etiology.