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The use of the internal mammary artery for coronary artery bypass grafting is common. We describe a patient with chronic renal insufficiency who had no need for dialysis, and who suffered from breast necrosis after coronary artery bypass grafting with internal mammary artery harvesting due to calciphylaxis. The histology report of the breast tissue showed mural vascular calcification and intima proliferation of small-sized to medium-sized vessels. This causes ischemic necrosis of the skin and septal panniculitis. We believe that this is the first case report of breast necrosis after coronary artery bypass grafting, due to calciphylaxis in a patient with known chronic renal insufficiency, without renal replacement therapy. [Copyright &y& Elsevier]