51-year-old female with a symptomatic right breast mass. Mammogram (BI-RADS b, scattered fibroglandular density) showed a 35 mm spiculate mass in the right upper outer quadrant Figure 3a and (b (Figure 2a and b), measuring up to 19 mm on ultrasound (Figure 2c) Figure 3c 14G core biopsy confirmed Grade 2 invasive NST. BCS was performed and histology showed a 60 mm Grade 3 NST with adjacent satellite nodules. The discrepancy in size between imaging and histology prompted post-operative breast MRI which demonstrated a 9 mm irregular enhancing mass in the right medial breast, distant from the site of surgery Figure 3d(Figure 3d). Second look ultrasound showed a corresponding 7 mm ill-defined mass in the medial right breast (Figure 3e). Figure 3e Core needle biopsy showed high-grade DCIS, and the patient proceeded to completion mastectomy. Final histology confirmed high-grade DCIS measuring 14 mm without invasive malignancy. BCS, breast conserving surgery;