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Fig. 1D —49-year-old woman who had undergone ipsilateral lumpectomy yielding ductal carcinoma in situ (DCIS) 3 years earlier. Sagittal image from T1-weighted 3D fat-suppressed fast spoiled gradient-echo sequence (17/2.4; flip angle, 35°) obtained after IV contrast injection on day of MRI-guided vacuum-assisted biopsy. Nipple and susceptibility artifacts (black arrow) serve as landmarks to show that biopsy obturator was placed at site of suspicious enhancement (white arrow). More background enhancement is evident on biopsy day because patient underwent imaging in different phase of menstrual cycle. Histologic examination of MRI vacuum-assisted breast biopsy specimens revealed foci of marked atypical ductal hyperplasia involving florid sclerosing adenosis. Histologic examination after surgical excision showed DCIS, solid and cribriform types, intermediate to high nuclear grade, apocrine cytologic features, and minimal necrosis, mostly involving sclerosing adenosis.