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Fig. 4. —77-year-old woman with calcifications caused by ductal carcinoma in situ (DCIS). Global magnification mammogram in true lateral projection shows several groups of calcifications (arrows) due to multifocal DCIS. One observer considered these coarse in morphology, multiple groups in distribution, and probably benign (short-term follow-up recommended, BI-RADS category 3). Another considered these to be punctate, multiple groups, and suspicious (biopsy recommended, BI-RADS category 4). Three observers considered these pleomorphic (one clustered, one linearly distributed, and one multiple groups) with assessments suspicious (BI-RADS category 4), highly suggestive of malignancy (BI-RADS category 5), and needs additional evaluation (BI-RADS category 0), respectively.





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