Figure 2. Lateral true spot-magnification mammogram shows new pleomorphic calcifications in multiple groups (arrows) due to intermediate-grade ductal carcinoma in situ (micropapillary type) in a 50-year-old woman. The experienced breast imagers did not agree on description or management of this case, which was considered typically benign by two of them and pleomorphic by a third. After discussion, the consensus was that the calcifications were not uniformly round but rather pleomorphic and thus suggestive of malignancy. This case showed the highest variance in management of all malignancies after training, with 81% of participants describing these as typically benign or punctate and probably benign before training, and only 30% describing them as pleomorphic and suspicious even after 1 day of BI-RADS training.