The case shows that not seeing a lesion on one modality while it is visible on another, is not a diagnosis. This case shows the incorrect use of BI-RADS 3, which is always supposed to be most likely benign. Workup was incomplete after the first lesion was managed.

Low volume breast readers or those with low levels of experience should most likely use a second opinion from an experienced senologist before using BI-RADS 3.