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Fig. 1C. —57-year-old woman with lesion variably termed "focal asymmetric density" versus "indistinct" mass. Spot compression mammogram was provided with comparison films. Three observers described finding as focal asymmetric density, considered normal (BI-RADS category 1, two observers), or needing sonography (BI-RADS category 0, one observer). Remaining two observers viewed finding as mass with indistinct borders and suspicious, needing biopsy (BI-RADS category 4). This distinction of focal asymmetric density from indistinct mass is one of the most problematic in mammographic interpretation, as was also seen in study of Baker et al. [7].